Unlawful dispensing practice of diazepam: a simulated client approach in community pharmacies in the north-west of Dar-es-Salaam region, Tanzania

Wigilya Padili Mikomangwa,Hamu Joseph Mlyuka,Ritah Mutagonda,Alphonce Ignace Marealle,Nassoro A Madende,Manase Kilonzi,Pacifique Ndayishimiye

doi:10.1186/s12913-019-4421-6

Wigilya Padili Mikomangwa, Hamu Joseph Mlyuka + Show 5 more

Open Access

https://doi.org/10.1186/s12913-019-4421-6

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Abstract

BackgroundThe use of psychotropic substances is controlled in most parts of the world due to their potential of abuse and addiction. Diazepam is one of the psychotropic substances which can be dispensed in community pharmacies in Tanzania. As per good dispensing practices and pharmacy laws, diazepam in the community pharmacies should strictly be stored in a controlled box and dispensed only by prescription. However, to our understanding little had been reported on availability and dispensing practices of diazepam in Tanzania.MethodsA descriptive cross-sectional study which involved 178 randomly selected registered community pharmacies in Kinondoni district was conducted from January to March 2018. Simulated client approach was used to assess the availability and dispensers practice about dispensing of diazepam. Location of pharmacies was categorized as being at the centre or periphery of the Kinondoni district. Chi-squared test was used for the analysis of categorical data using SPSS version 23. The p-value of < 0.05 was considered significant.ResultThe total of 178 community pharmacies were visited, the majority of the dispensers (89.1%) encountered were female. Most (69.1%) of the studied pharmacies were located at the centre of Kinondoni district. Diazepam was available in 91% of community pharmacies and 70% of dispensers issued diazepam without prescription.ConclusionDiazepam was available in most of the community pharmacies in Kinondoni district, and the majority of the dispensers dispensed diazepam without prescription. This calls for the regulatory authorities to be more vigilant on the availability of diazepam and enhance the provision of ethical pharmacy practice in the community pharmacies.

Highlights

The use of psychotropic substances is controlled in most parts of the world due to their potential of abuse and addiction
Availability of diazepam in community pharmacies Out of 178 community pharmacies visited, diazepam was available in 91% of the pharmacies (Fig. 1)
The difference in the presence of diazepam based on location was statistically significant (P = 0.001) (Table 2)

Summary

Introduction

The use of psychotropic substances is controlled in most parts of the world due to their potential of abuse and addiction. Diazepam is one of the psychotropic substances which can be dispensed in community pharmacies in Tanzania. To our understanding little had been reported on availability and dispensing practices of diazepam in Tanzania. The misuse of drugs such as sedative-hypnotics (mostly barbiturates and benzodiazepine), opioids, Diazepam has higher abuse potential than other members in the benzodiazepine (BDZ) group because of its long duration of action, affordability and availability [5]. Misuse of diazepam as well as other psychotropic substances lead to physiological and psychological addiction [6] and can be fatal [7]. The risk is especially high when an individual combines diazepam with other central nervous system (CNS) depressants such as alcohol, opioids and barbiturates [4].

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