Shrivastava Birendra, Bajracharya Omi, Shakya Rajani
School of Pharmaceutical Sciences, Jaipur National University, Jagatpura, Jaipur 302017, India.
Department of Clinical Pharmacology and Therapeutics, KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal.
Explor Res Clin Soc Pharm. 2022 Feb 26;5:100117. doi: 10.1016/j.rcsop.2022.100117. eCollection 2022 Mar.
United Nations Sustainable Development Goal 3 outlines the target of reducing premature mortality from non-communicable diseases by one third through prevention and treatment by 2030. In low and middle-income countries (LMICs) like Nepal, a significant number of people do not have accessible and affordable healthcare services available to them, leading to self-medication practices (SMP). Limited numbers of health professionals, ineffective regulation and easy availability of prescription medicines encourage the use of inappropriate SMP, which could result in health risks.
The objection of the study is to test the application of Analytical Hierarchy Process (AHP) for prioritizing the intervention measures for preventing inappropriate SMP.
The 25 experts were included in the study, out of which only 16 experts passed the consistency test. Data were collected using a structured questionnaire by the application of AHP model for ranking the intervention measures for preventing inappropriate SMP from March 2020 to May 2020. During this process, the purposively selected experts compared seven intervention measures based on three criteria: control use of prescription and non-prescription medicine, knowledge regarding the medicine and its use, and minimizing healthcare cost.
The criteria, "control use of prescription and non-prescription medicine" was judged 3.58 times and 1.53 times more important than to "minimize the healthcare cost" and "knowledge regarding the medicine and its use" respectively. "Regulation of prescription and non-prescription dispensing practice" was the most prioritized intervention measure to prevent inappropriate SMP with a priority score of 20.68% followed by the "accessibility of healthcare system" (19.27%) and "awareness program for the consumers" (17.13%).
The AHP method can be used in decision-making related to prioritizing the intervention measures to prevent inappropriate SMP. Among the seven intervention measures considered, "regulation of prescription and non-prescription dispensing practice" was the most preferred intervention measure to improve SMP followed by "access to healthcare" and an "awareness program".
联合国可持续发展目标3概述了到2030年通过预防和治疗将非传染性疾病导致的过早死亡率降低三分之一的目标。在尼泊尔等低收入和中等收入国家，大量民众无法获得可及且负担得起的医疗保健服务，导致了自我药疗行为（SMP）。卫生专业人员数量有限、监管不力以及处方药易于获取，助长了不恰当的自我药疗行为，这可能会带来健康风险。
本研究的目的是测试层次分析法（AHP）在对预防不恰当自我药疗行为的干预措施进行优先级排序方面的应用。
25名专家参与了本研究，其中只有16名专家通过了一致性检验。2020年3月至2020年5月期间，采用结构化问卷，通过应用AHP模型收集数据，对预防不恰当自我药疗行为的干预措施进行排序。在此过程中，经过有目的选择的专家根据三个标准对七种干预措施进行了比较：控制处方药和非处方药的使用、药品及其使用知识、以及尽量降低医疗成本。
“控制处方药和非处方药的使用”这一标准分别被判定为比“尽量降低医疗成本”和“药品及其使用知识”重要3.58倍和1.53倍。“规范处方药和非处方药配药行为”是预防不恰当自我药疗行为的最优先干预措施，优先得分率为20.68%，其次是“医疗保健系统的可及性”（19.27%）和“消费者意识项目”（17.13%）。
层次分析法可用于与预防不恰当自我药疗行为的干预措施优先级排序相关的决策。在所考虑的七种干预措施中，“规范处方药和非处方药配药行为”是改善自我药疗行为的最优选干预措施，其次是“获得医疗保健服务”和“意识项目”。
