Popoola Olanrewaju Olamide, Adebisi Igbagboyemi Adebowale, Adeyemi Adebowale Sylvester, Adepitan Damilola Samson, Oladeru Opeyemi Fortunate
HealthPlus, Lagos, Nigeria.
Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Nigeria.
Front Public Health. 2025 May 13;13:1495328. doi: 10.3389/fpubh.2025.1495328. eCollection 2025.
Given the accessibility of community pharmacists as the first point of care in Nigeria and their expanding role in optimizing public health, it is critical that they employ evidence-based, ethical practices. This study assessed ethical practices and identified drivers of unethical practices among community pharmacists in Nigeria.
A convergent-parallel mixed method study design was employed, collecting quantitative and qualitative data, which were analyzed using SPSS and inductive content analysis.
Most pharmacists maintained patients' confidentiality (93.2%), and disclosed side effects of medicines to patients (80.3%). Nearly half (48.9%) dispensed antibiotics without prescriptions and more than one-third purchased medicines from the unregulated open market (38.4%). Conversely, only 53.4% performed quality checks to identify possible or suspected substandard and falsified medicines. Pharmacists who regularly consulted the PCN code of ethics were less likely to dispense antibiotics without prescriptions ( = 0.011), stock medicines not approved by NAFDAC ( = 0.010), or purchase from open markets ( = 0.027). Key drivers of unethical pharmacy practices include poor physician-pharmacist interprofessional collaboration (76.3%), patient pressure (73.9%), and managerial pressure to meet sales targets (70.3%). Qualitative responses highlighted competitive pressure, expressed as fear of losing clients, poor working conditions, poor regulation, and unethical, profit-driven, managerial practices as drivers of unethical pharmacy practices. Potential limitations to this study include recall bias and the Hawthorne effect.
Pharmacists' unethical practices potentially contribute to the prevalence of substandard and falsified medicines, and antimicrobial resistance. Improved regulations, improved remuneration, providing incentives for professionalism, training on ethics and improved multidisciplinary collaborations could promote ethical community pharmacy practices.
鉴于在尼日利亚社区药剂师是首诊医疗服务的可及提供者，且他们在优化公共卫生方面的作用不断扩大，他们采用循证且符合道德规范的做法至关重要。本研究评估了尼日利亚社区药剂师的道德行为，并确定了不道德行为的驱动因素。
采用了收敛平行混合方法研究设计，收集定量和定性数据，分别使用SPSS和归纳性内容分析法进行分析。
大多数药剂师能对患者信息保密（93.2%），并向患者披露药物副作用（占80.3%）。近一半（48.9%）的药剂师在无处方情况下配发抗生素，超过三分之一的药剂师从不规范的开放市场购买药品（占38.4%）。相反，只有53.4%的药剂师进行质量检查以识别可能或疑似的不合格及假药。经常查阅药剂师理事会道德规范的药剂师在无处方情况下配发抗生素（P = 0.011）、储存未获国家食品药品管理局批准的药品（P = 0.010）或从开放市场采购药品（P = 0.027）的可能性较低。不道德配药行为的主要驱动因素包括医患间不良的跨专业协作（76.3%）、患者压力（73.9%）以及为实现销售目标的管理压力（70.3%）。定性反馈强调竞争压力，表现为担心失去客户、工作条件差、监管不力以及不道德的、受利润驱动的管理做法是不道德配药行为的驱动因素。本研究的潜在局限性包括回忆偏倚和霍桑效应。
药剂师的不道德行为可能会导致不合格及假药的泛滥以及抗菌药物耐药性。加强监管、提高薪酬、激励专业精神、开展道德培训以及改善多学科协作可促进社区药房的道德行为。
