Guadie Muluneh, Asemahagn Mulusew Andualem, Tefera Abekyelesh, Melkam Wondim, Habteweld Habtemariam Alekaw, Derebe Dagninet
Department of Regional Regulatory Offices, Amhara Health Bureau, Bahir Dar, Ethiopia.
School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia.
Integr Pharm Res Pract. 2023 Jul 25;12:157-170. doi: 10.2147/IPRP.S415375. eCollection 2023.
In developing countries like Ethiopia, medicines wastage becomes a major healthcare system challenge. However, data that displayed the type, extent, and contributing factors of medicines wastage were limited.
A health facility-based explanatory sequential mixed study was conducted from December 2021 to February 2022. One drug and therapeutics committee (DTC) and one store man per health facility, working during the study period were included for their perception of medicines wastage and possible causes. As key informants, 1 Chief Executive Officer (CEO) and 1pharmacy head were also included per facility. In total, 80 participants were included in this study. The quantitative data to determine the magnitude of medicine wastage were collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 25.
The overall medicines wastage in the three consecutive years was 6.3%. The trend over the three years indicated that medicines wastage is 6.5%, 5.9%, and 6.5% in 2011, 2012, and 2013 Ethiopian Fiscal Year (EFY), respectively. The medicine wastage rate has been increasing nearly by 3% between 2011/2012 and 2012/2013. The main sources of wastage of medicines were expiry (99.3%). The perceived reasons for such medicine's wastage were near-expiry medicines (<6 months) being delivered to the health facilities by suppliers, poor communication and coordination with key stakeholders, and the presence of overstocked medicines due to improper forecasting of need in the facilities.
There is an excessive rate of medicines wastage which needs immediate mitigation by exchanging nearly expired medicines with other health facilities, communicating with suppliers and even prescribers, using auditable pharmaceutical transactions and services (APTS), providing continuous training, pursuing quality and safety medicines reuse scheme, implementation of pharmacist waste-reducing activities in all stages of the pharmaceutical supply chain, reducing medication amounts in stock, and through the use of electronic stock management tools.
在埃塞俄比亚等发展中国家,药品浪费成为医疗系统面临的一项重大挑战。然而,有关药品浪费的类型、程度及促成因素的数据有限。
于2021年12月至2022年2月开展了一项基于医疗机构的解释性序列混合研究。每个医疗机构中在研究期间工作的一个药品与治疗学委员会(DTC)成员和一名仓库管理员被纳入研究,以了解他们对药品浪费及其可能原因的看法。每个机构还纳入1名首席执行官(CEO)和1名药房负责人作为关键信息提供者。本研究共纳入80名参与者。使用结构化访谈式问卷收集用于确定药品浪费程度的定量数据,并使用SPSS 25版进行分析。
连续三年的总体药品浪费率为6.3%。三年趋势表明,在2011年、2012年和2013年埃塞俄比亚财政年度(EFY),药品浪费率分别为6.5%、5.9%和6.5%。2011/2012年至2012/2013年期间,药品浪费率几乎上升了3%。药品浪费的主要来源是过期(99.3%)。造成此类药品浪费的可感知原因包括供应商向医疗机构交付接近有效期的药品(<6个月)、与关键利益相关者沟通和协调不畅以及由于对机构内需求预测不当导致药品库存过多。
药品浪费率过高,需要立即采取缓解措施,包括与其他医疗机构交换接近过期的药品、与供应商甚至开处方者进行沟通、使用可审计的药品交易和服务(APTS)、提供持续培训、推行优质安全的药品再利用计划、在药品供应链的各个阶段实施药剂师减少浪费的活动、减少库存药品数量以及使用电子库存管理工具。