Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, P.O Box LG 13, Accra, Ghana.
Ghana College of Pharmacists, Cantonments, P.O Box CT10740, Accra, Ghana.
Malar J. 2019 Jul 30;18(1):260. doi: 10.1186/s12936-019-2897-5.
Despite recent strides made towards reducing the emergence of artemisinin resistance, inappropriate dispensing practices for anti-malarials in both private and public sectors affect treatment outcomes negatively. In Ghana, private retail pharmacies are the most accessible health facilities for managing diseases of common occurrence. However, there is growing concern about the number of patients harmed by dispensing errors in the management of malaria in retail pharmacies. Although considerable work has been done in this area, several questions regarding dispensing practices remain unanswered. This study, therefore, sought to investigate the predictors of appropriate dispensing practices for anti-malarials in community pharmacies in the La Nkwantanang-Madina municipality of Greater Accra, Ghana.
A cross-sectional analytic study was conducted in sixty-one randomly selected community pharmacies in the La Nkwantanang-Madina. Data from 230 clients and 106 dispensers were analysed. It was checked for internal consistency and completeness then entered and analysed using STATA I/C version 14.0. Frequencies, Chi square tests, and logistic regression analyses were conducted, accounting for clustering.
Of the 106 dispensers interviewed, 71.4% were medicine counter assistants. The mean age of dispensers was 30.4 years (SD 8.8). Over 88.0% of clients were advised to complete the full course of their anti-malarials. However, the 8-h loading dose principle for artemether-lumefantrine was not explained to 88.3% of the clients. More than half of the clients (52.2%) were given appropriate dispensing information on anti-malarial use. Most clients (66.1%), were dispensed anti-malarials without malaria tests. Dispensers with more than a 10-years experience were less likely to dispense artemisinin-based combinations appropriately relative to dispensers with less than 2 years experience (AOR = 0.04, 95% CI 0.002-0.802 p-value = 0.036) while pharmacy interns were about 19 times more likely (AOR = 18.5, 95% CI 1.40-245.6 p-value = 0.03) to dispense artemisinin-based combinations appropriately compared to pharmacists.
Dispensing practices for anti-malarials is unsatisfactory. There is a need to enforce existing legislation with educational programmes directed towards dispensers especially those with more than 10 years experience. Specific adherence to the World Health Organization Test, Treat and Track initiative should be encouraged to ensure effective use of anti-malarials.
尽管最近在减少青蒿素耐药性方面取得了进展，但私人和公共部门抗疟药物的不当配药做法仍对治疗结果产生负面影响。在加纳，私营零售药店是管理常见病最便捷的医疗设施。然而，人们越来越担心在零售药店管理疟疾时，因配药错误而伤害患者的人数。尽管在这方面已经做了大量工作，但仍有几个关于配药做法的问题尚未得到解答。因此，本研究旨在调查加纳大阿克拉地区拉恩克坦南-马迪纳市社区药店中抗疟药物适当配药做法的预测因素。
在拉恩克坦南-马迪纳市的 61 家随机选择的社区药店进行了横断面分析研究。对 230 名患者和 106 名配药者的数据进行了分析。检查了内部一致性和完整性，然后使用 STATA I/C 版本 14.0 输入和分析。进行了频率、卡方检验和逻辑回归分析，同时考虑了聚类。
在接受采访的 106 名配药者中，有 71.4%是药店柜台助理。配药者的平均年龄为 30.4 岁（SD 8.8）。超过 88.0%的患者被建议完成完整的抗疟疗程。然而，88.3%的患者没有被告知青蒿素-本芴醇的 8 小时负荷剂量原则。超过一半的患者（52.2%）获得了关于抗疟药物使用的适当配药信息。大多数患者（66.1%）在没有疟疾检测的情况下配了抗疟药物。与经验不足 2 年的配药者相比，经验超过 10 年的配药者不太可能正确配给青蒿素类复方药物（AOR=0.04，95%CI 0.002-0.802，p 值=0.036），而药剂实习生则更有可能（AOR=18.5，95%CI 1.40-245.6，p 值=0.03）正确配给青蒿素类复方药物。
抗疟药物的配药做法不尽如人意。需要执行现有法规，并针对配药者，特别是经验超过 10 年的配药者开展教育计划。应鼓励遵守世界卫生组织的检测、治疗和跟踪倡议，以确保抗疟药物的有效使用。
