Athuraliya N, Walkom E J, Dharmaratne S, Robertson J
Department of Medicine, The Maitland Hospital Clinical School, 550-560 High Street, Maitland, 2320 NSW Australia.
Department of Clinical Pharmacology, School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.
J Pharm Policy Pract. 2016 Nov 25;9:38. doi: 10.1186/s40545-016-0091-5. eCollection 2016.
There is substantial evidence of poor dispensing practices with inadequate packaging and labelling of medicines, and limited advice on their usage in low and middle-income countries (LMICs). We examined the labelling and packaging of medicines identified during a survey of 1322 households in six regions of Sri Lanka between 2010 and 2013 conducted using the World Health Organization (WHO) methodology for household surveys. We compared medicines obtained from public and private sources and asked interviewees if they understood how to take the medicines.
Packaging was considered adequate when the primary package was an envelope or closable container holding only one medicine. Adequate labels were legible and included medicine name, dose and expiration date. Interviewers assessed whether respondents knew how to take the medicines.
Of 1322 households, 1253 households (94.8%) had at least one medicine; 84% were classified as western medicines and 16% traditional medicines. Of 5756 western medicines identified, 82.1% were adequately packaged, 43.3% adequately labelled and 41.4% both adequately packaged and labelled. Participants stated that they understood the label and knew how to take 96% of the medicines. Private medicine sources had more adequately packaged medicines than public sources (87.7% vs 73.5%; OR 2.58, 95% CI 2.23, 2.99) and more adequately labelled medicines (52.2% vs 27.4%; OR 2.90, 95% CI 2.57, 3.26).
Inadequate packaging and labelling of medicines remain a concern in Sri Lanka. Commitment to Good Pharmacy Practices, investments in staff education and training and adequate dispensing resources (containers and labels), particularly in the public sector, are needed to address sub-optimal dispensing practices. Ageing populations with more chronic diseases requiring polypharmacy and complex medicine regimens increase the need for appropriately packaged and labelled medicines.
有大量证据表明，在低收入和中等收入国家（LMICs），药品调配做法不佳，包装和标签不完善，且关于药品使用的建议有限。我们对2010年至2013年期间在斯里兰卡六个地区对1322户家庭进行调查时所发现的药品的标签和包装进行了研究。该调查采用了世界卫生组织（WHO）的家庭调查方法。我们比较了从公共和私人来源获得的药品，并询问受访者是否了解如何服用这些药品。
当主要包装为仅装有一种药品的信封或可封闭容器时，包装被认为是合适的。合适的标签应清晰可读，并包括药品名称、剂量和有效期。访谈者评估受访者是否知道如何服用这些药品。
在1322户家庭中，1253户家庭（94.8%）至少有一种药品；84%被归类为西药，16%为传统药品。在识别出的5756种西药中，82.1%包装合适，43.3%标签合适，41.4%包装和标签均合适。参与者表示他们理解标签并知道如何服用96%的药品。私人药品来源的包装合适的药品比公共来源更多（87.7%对73.5%；比值比2.58，95%置信区间2.23，2.99），标签合适的药品也更多（52.2%对27.4%；比值比2.90，95%置信区间2.57，3.26）。
药品包装和标签不完善在斯里兰卡仍然是一个问题。需要致力于良好药房规范，投资于员工教育和培训以及充足的调配资源（容器和标签），特别是在公共部门，以解决不理想的调配做法。患有更多慢性病需要联合用药和复杂药物治疗方案的老年人口增加了对包装和标签合适的药品的需求。
