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孟加拉国拉杰沙希市私立药店药品配药模式评估。

Evaluation of medicines dispensing pattern of private pharmacies in Rajshahi, Bangladesh.

作者信息

Saha Shuvashis, Hossain Md Tawhid

机构信息

Rajshahi Medical College, University of Rajshahi, 6002, Rajshahi, Bangladesh.

Rajshahi Medical College Hospital, Rajshahi, Bangladesh.

出版信息

BMC Health Serv Res. 2017 Feb 13;17(1):136. doi: 10.1186/s12913-017-2072-z.

Abstract

BACKGROUND

In developing country like BANGLADESH, people depend more on pharmacies due to expediency, shorter waiting time, cost reduction, availability of credit and flexible opening hours. The aim of this study was to investigate medicines dispensing patterns of the pharmacies in RAJSHAHI, BANGLADESH and to identify and analyze contribution of drugsellers and quacks in irrational drug use.

METHODS

This cross-sectional study was conducted during January 2016 - April, 2016 in 75 randomly selected private pharmacies including both licensed and unlicensed pharmacies of covering LAKSHMIPUR area.

RESULT

During the whole study process, total 7944 clients visited the pharmacies under observation and 24,717 medicines were dispensed. 22.70% of all these drugs were sold without a prescription. Out of the 5610 items dispensed without prescription, 66.2% were dispensed on the request of clients themselves and 33.8% on the recommendation of a drug seller. Number of medicine in a prescription was highly variable ranging from 2 to 5 medicines per prescriptions (mean = 3.03). The average number of medicines dispensed from each of the pharmacies during the observation period was 392, varied pharmacy to pharmacy - ranging from 194 to 588. Lowest selling medicines were sedative and hypnotics and highest selling medicines were antimicrobials. The recommendation rate for antibiotics was highest for the quacks (26.48%) though the major amount of the antimicrobials (n = 3039, 65.83%) were dispensed on prescription. Macrolides, quinolones, metronidazoles and cephalosporins are most favourite drug of quacks, clients and pharmacists.

CONCLUSION

Majority of medicines were dispensed irrationally without any prescription and over the counter dispensing of many low safety profile drugs was common. The results and discussion presented in this paper will be helpful to provide a baseline to redirect further studies in this area.

摘要

背景

在孟加拉国这样的发展中国家,由于方便、等待时间短、成本降低、可赊购以及营业时间灵活,人们更多地依赖药店。本研究的目的是调查孟加拉国拉杰沙希市药店的药品配药模式,并确定和分析药商和庸医在不合理用药中的作用。

方法

本横断面研究于2016年1月至2016年4月期间在拉克希米布尔地区随机选取的75家私立药店进行,包括有执照和无执照的药店。

结果

在整个研究过程中,共有7944名顾客光顾了观察中的药店,共配药24717剂。所有这些药品中有22.70%是无处方销售的。在5610剂无处方配出的药品中,66.2%是应顾客自身要求配出的,33.8%是在药商的推荐下配出的。每张处方中的药品数量差异很大,每张处方从2种到5种药品不等(平均=3.03)。观察期间每家药店配出的药品平均数量为392剂,药店之间各不相同,从194剂到588剂不等。销量最低的药品是镇静催眠药,销量最高的药品是抗菌药。庸医开出抗生素的推荐率最高(26.48%),不过大部分抗菌药(n=3039,65.83%)是凭处方配出的。大环内酯类、喹诺酮类、甲硝唑类和头孢菌素类是庸医、顾客和药剂师最喜欢的药物。

结论

大多数药品是在没有任何处方的情况下不合理配出的,许多安全性较低的药品非处方配药很常见。本文给出的结果和讨论将有助于为该领域的进一步研究提供一个重新定向的基线。

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