Private Pharmacies Research Articles

Availability, pricing, and affordability of essential medicines for pediatric population in Malawi.

Lack of access to essential medicines negatively impacts on the quality of healthcare delivery and increases morbidity and mortality, especially to the vulnerable pediatric population. We assessed the availability, pricing, and affordability of pediatric formulations in Malawi. The study was conducted in 76 health facilities (public, faith-based and private pharmacies, and clinics) from the northern and southern regions of Malawi from March to May 2023. We adapted the WHO/HAI method for the assessment of both availability and pricing of medicines. Data on availability were collected from stock card records using a WHO/HAI template and medicine prices were provided by the pharmacy personnel who were managing the facilities. Availability of medicines was calculated as the percentage of facilities which had a stock of the respective medicine at the time of data collection while medicine prices was assessed by calculating the median prices of each medicine. To assess the affordability of the medicines, we calculated the number of days it takes for a person who is receiving the government-set minimum wage to work to pay for a treatment course of common indications. The study was approved by the KUHES ethics committee under the numbers U.12/22/3900 and U.12/22/3903. The overall availability of pediatric medicines was 38.1% for public health facilities, 53.7% for private retail pharmacies and drug stores, 49.5% for private clinics and 48.3% for Christian Health Association of Malawi (CHAM) facilities. We found the illegal availability of prescription-only medicines of up to 54% in medicine stores. Medicine median prices were higher in the private clinics followed by retail pharmacies and drugs stores. CHAM had the lowest median prices for medicines of all the sectors. More than 50% of medicines were found to be affordable as less than a day's wage was required to purchase the treatment. We found poor availability of pediatric formulation among public, CHAM, and private sectors in Malawi. This may affect the quality of care among pediatric patients and therefore contribute to morbidity and mortality in Malawi. The supply of medicines and health commodities needs to consider needs of special populations such as children to achieve universal health coverage.

Availability of Dispensing and Storage Facilities at Public and Community Pharmacies at Bahir Dar and Gondar Towns.

The availability of various facilities that aid in providing expected services is necessary for the practice of pharmacy, which aims to make the best use of medications and other healthcare products and services. Therefore, the aim of this study was to assess the availability of dispensing and storage facilities at public and community pharmacies in Bahir Dar and Gondar towns. In Gondar and Bahir Dar towns' public and private pharmacies, a facility-based cross-sectional study was conducted from July 2023 to September 2023. All pharmacy areas that were open during data collection were included in the study. The frequency and percentage were calculated using descriptive statistics. From 239 pharmacies, 208 (87.0%) of them were open during data collection, and they are included in the study.The water supply and dispensing counter were available in the dispensing area in 79.3% and 60.1% of instances, respectively. They also had adequate room for storage (92.8%), dispensing (92.8%), and receiving (95.7%) of medicines. Additionally, about 98.1% of the facilities had shaded, ventilated, and dry areas. A therapeutic order was the most often used method (59.6%) for medication organization. Merely 1.9% of participants did not employ a strategy to arrange their medications. A refrigerator (88.0%), a refrigerator thermometer (91.3%), a spoon or spatula (81.3%), a separate storage facility (74.5%), a cold room (68.8%), a lockable cabinet (90.9%), a tablet counter (69.2%), and a fire extinguisher (safety device) (88%) were among the various storage equipment the majority of the pharmacies in the survey had. Nonetheless, air conditioning was absent from the majority (53.4%) of pharmacy facilities. Few pharmacies need to make improvements to their facilities in order to encourage convenient drug storage and dispensing practices, even though the majority of the pharmacies surveyed had all the necessary equipment and infrastructure. In addition to initiating the pharmacies to provide good practices of dispensing and storage, facility-focused initiation and regulation should be obtained to ensure full availability of the facilities.

A Pharmacy-Based Cross-Sectional Study to Assess the Antibiotic Prescription Pattern by Medical and Dental Practitioners in Saudi Arabia

ABSTRACT Introduction: The misuse and overuse of antibiotics in dental practice are well known and have become widespread worldwide. Its potential effect and high risk of serious reaction have emphasized the need to reduce and limit the precipitation. In this study we aimed to identify the prevalence, type, dose, and duration of antibiotics prescribed by general medical and dental practitioners in Saudi Arabia. Materials and Methods: This cross-sectional study was performed from April 2020 to December 2020. A total of 45,100 antibiotic prescriptions were collected from different governmental and private pharmacies and screened to be included in this study. Data extraction from all prescriptions followed a standardized form that included the following information: Doctor specialty, type of antibiotic, duration, and dose of antibiotic. Results: A total of 38,175 antibiotic prescriptions prescribed by licensed doctors practicing in governmental or private hospitals were included in this study. Thirty-five thousand one hundred and seventy-eight (92%) outpatient antibiotics were prescribed by medical practitioners, and 2997 (8%) antibiotics were prescribed by dentists. The most commonly prescribed antibiotic was Augmentin (60%), followed by metronidazole and amoxicillin (35%). The most common dose and duration prescribed by dentists for Augmentin was 625 mg, 3 times per day for 5 days, whereas that of metronidazole was 500 mg, 3 times per day for 7 days. Prescribed dose and duration of amoxicillin was 500 mg, 3 times per day for 7 days. Conclusions: This study helps in understanding healthcare practitioners’ patterns and adds to the knowledge on how to deal with odontogenic infections. Further national studies are recommended to include more regions in Saudi Arabia and to illustrate the misuse of outpatient antibiotics.

Overview of Sales and Investment in Drugs Branded by Pharmacy "X" in Kampung Satu District, Tarakan City Using ABC Analysis for the 2022 Period

Pharmacies as facilities that are authorized to manage the inventory of pharmaceutical supplies need to anticipate inventory problems, both over stock and out stock. Pareto ABC analysis is one solution to overcome planning and procurement problems which tend to be ineffective and inefficient. This research aims to determine the sales and investment value of branded drugs at one of the private pharmacies in Tarakan City. This research is a retrospective study using the Pareto ABC analysis method on branded drug sales data in 2022. Based on sales data, 761 types of branded drugs were analyzed. The data is then grouped based on sales value. As for the results obtained, group A consisted of 189 types of drugs, or the equivalent of 24.84% of the total types of drugs, with a sales value of 17,986 items and an investment value of IDR. 209,828,250. Meanwhile, group B consists of 205 types of drugs, or the equivalent of 26.94% of the total types of drugs, with a sales value of 5,155 items and an investment value of IDR. 60,177,500. Meanwhile, for group C there are 367 types of drugs, or 48.23% of all types of drugs, with a sales value of 2,573 items and a total investment value of IDR. 30,107,100. This indicates that inventory monitoring and management can be adjusted to the characteristics and investment size of each drug category.

Affordability of Paediatric Oral Anti-Infective Medicines in a Selected District, Sri Lanka

In this cross-sectional descriptive study conducted in the Ratnapura district, Sri Lanka, we assessed the affordability of oral pediatric anti-infective medicines (OPAIMs). Using a modified WHO/HAI medicinal price methodology, we examined the availability, median price ratios (MPRs), mean percentage difference, and affordability of the standard treatment of the originator brand (OB) and lowest-priced generic (LPG) OPAIMs in 30 private and 2 state-owned pharmacies. The study revealed disparities in availability, with only 50% of private pharmacies offering all 11 medicinal drugs in their generic form. The MPRs of OPAIMs for OB and LPG varied, with three drugs exceeding the financially acceptable MPR of 2 (albendazole, amoxicillin, and erythromycin). The standard treatment with LPGs costs between 0.17 and 0.85 and between 0.06 and 0.28 days’ wages for the lowest daily salary of the private sector and unskilled public employees, respectively. We identified erythromycin and albendazole as having less than 50% availability in their generic form in private pharmacies. To address these findings, we recommend frequent pricing revisions based on exchange rates and associated costs, coupled with the establishment of a transparent scientific criterion to subsidize essential medicines deemed “unaffordable.” Failure to implement such measures amidst economic crises may adversely impact financial access to essential medications.

The Economics of the Public Option: Evidence from Local Pharmaceutical Markets

We study the effects of competition by state-owned firms, leveraging the decentralized entry of public pharmacies to local markets in Chile. Public pharmacies sell the same drugs at a third of private pharmacy prices, because of stronger upstream bargaining and market power in the private sector, but are of lower quality. Public pharmacies induced market segmentation and price increases in the private sector, which benefited the switchers to the public option but harmed the stayers. The countrywide entry of public pharmacies would reduce yearly consumer drug expenditure by 1.6 percent. (JEL D22, I18, L32, L65, O14)

‘When I tried to explain, they shouted back at me!’: exploring how community pharmacists navigate tensions implementing antimicrobial stewardship in Vietnam

ABSTRACT Antimicrobial resistance is a major global and national health challenge, accelerated by ‘irrational’ antibiotic use. In response, Vietnam has been implementing a public health plan of antimicrobial stewardship since 2013 to reduce antibiotic sales in community pharmacies, although it has had limited effect. Given that private pharmacies are increasingly the entry point to access healthcare, reflective of the inhibited accessibility of primary healthcare, understanding how the positioning of community pharmacists shapes the delivery of antimicrobial stewardship plans warrant further investigation. This qualitative analysis draws on data from 24 in-depth interviews with licensed community pharmacists in Vietnam. Interviewees described being constrained in rationing the sale of antibiotics by tensions within their professional role, in which the delivery of antimicrobial stewardship within their public health commitments rubs up against commercial and social obligations to their livelihoods and communities respectively. The concept of ‘resistance’ provides insight into what obstructs the integration of national antimicrobial stewardship guidance and policy, hindering the transformation of local practices concerning antibiotic sales at the community level. Findings reveal opportunities to recast community pharmacists as ‘productive anchors’ who can facilitate the appropriate use of antibiotics and strengthen links to primary care within the local context. Structural changes are needed, however, so that people do not use antibiotics as a proxy for health care. Improving the accessibility of primary healthcare would also curtail the reliance on community pharmacists’ to dispense antibiotics as a local mechanism of financial protection and social care within community.

Measuring the performance of computer vision artificial intelligence to interpret images of HIV self-testing results.

HIV self-testing (HIVST) is highly sensitive and specific, addresses known barriers to HIV testing (such as stigma), and is recommended by the World Health Organization as a testing option for the delivery of HIV pre-exposure prophylaxis (PrEP). Nevertheless, HIVST remains underutilized as a diagnostic tool in community-based, differentiated HIV service delivery models, possibly due to concerns about result misinterpretation, which could lead to inadvertent onward transmission of HIV, delays in antiretroviral therapy (ART) initiation, and incorrect initiation on PrEP. Ensuring that HIVST results are accurately interpreted for correct clinical decisions will be critical to maximizing HIVST's potential. Early evidence from a few small pilot studies suggests that artificial intelligence (AI) computer vision and machine learning could potentially assist with this task. As part of a broader study that task-shifted HIV testing to a new setting and cadre of healthcare provider (pharmaceutical technologists at private pharmacies) in Kenya, we sought to understand how well AI technology performed at interpreting HIVST results. At 20 private pharmacies in Kisumu, Kenya, we offered free blood-based HIVST to clients ≥18 years purchasing products indicative of sexual activity (e.g., condoms). Trained pharmacy providers assisted clients with HIVST (as needed), photographed the completed HIVST, and uploaded the photo to a web-based platform. In real time, each self-test was interpreted independently by the (1) client and (2) pharmacy provider, with the HIVST images subsequently interpreted by (3) an AI algorithm (trained on lab-captured images of HIVST results) and (4) an expert panel of three HIVST readers. Using the expert panel's determination as the ground truth, we calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for HIVST result interpretation for the AI algorithm as well as for pharmacy clients and providers, for comparison. From March to June 2022, we screened 1,691 pharmacy clients and enrolled 1,500 in the study. All clients completed HIVST. Among 854 clients whose HIVST images were of sufficient quality to be interpretable by the AI algorithm, 63% (540/854) were female, median age was 26 years (interquartile range: 22-31), and 39% (335/855) reported casual sexual partners. The expert panel identified 94.9% (808/854) of HIVST images as HIV-negative, 5.1% (44/854) as HIV-positive, and 0.2% (2/854) as indeterminant. The AI algorithm demonstrated perfect sensitivity (100%), perfect NPV (100%), and 98.8% specificity, and 81.5% PPV (81.5%) due to seven false-positive results. By comparison, pharmacy clients and providers demonstrated lower sensitivity (93.2% and 97.7% respectively) and NPV (99.6% and 99.9% respectively) but perfect specificity (100%) and perfect PPV (100%). AI computer vision technology shows promise as a tool for providing additional quality assurance of HIV testing, particularly for catching Type II error (false-negative test interpretations) committed by human end-users. We discuss possible use cases for this technology to support differentiated HIV service delivery and identify areas for future research that is needed to assess the potential impacts-both positive and negative-of deploying this technology in real-world HIV service delivery settings.

Survey and analysis of accessibility, availability, and affordability of topical glaucoma medicines.

Affordability and availability of medicines is a growing global challenge for health-care systems. Access to medicines is recognized as an important determinant of treatment adherence. The access to glaucoma medicines and how it affects glaucoma management are not known. The purpose of this study was to determine the availability, affordability, and accessibility of topical intraocular pressure (IOP) -lowering eye drops in Haryana state of northern India using the World Health Organization (WHO)/Health Action International (HAI) methods. A cross-sectional study was done to collect data on prices and availability of glaucoma topical medications in public and private sector pharmacies and retail outlets using the WHO/HAI methodology between October 2021 and January 2022. The availability and affordability of topical glaucoma medicines was determined. Comparison of the local price with international prices was done by calculating the median price ratio (MPR). A total of 191 facilities were randomly sampled across 11 ( n = 55) urban, 29 ( n = 92) semi-urban, and 44 ( n = 44) rural places during the study period. The availability of topical medication for glaucoma was low (35.7 ± 22.3) across all sampled sites and all classes of topical glaucoma medications. The median price of topical medication and availability were negatively correlated, Pearson's coefficient r (18) = -0.44, P 0.05, though the relationship was weak. A lowest paid, unskilled Indian government worker must spend between 15% and 203% of their daily wage to acquire a glaucoma medication. The availability and accessibility of topical glaucoma medications was low in this survey.

Establishing competency based internship program through participatory action research in a private pharmacy college in the Eastern Province of Saudi Arabia

ObjectivesTo use Participatory Action Research (PAR) methodology to develop a competency-based training (CBT) program for Bachelor of Pharmacy interns at Mohammed Al-Mana College for Medical Sciences (MACHS), Dammam, Saudi Arabia, based on the International Pharmaceutical Federation (FIP) Global Competency Framework. MethodsThe MACHS Pharmacy Department Training Unit developed a competency-based training (CBT) framework over 6 cohorts of interns based on the FIP Global Competency Framework using the Participatory Action Research (PAR) methodology. Assignments were set throughout the training period to support competency development. Assessment methods used for the evaluation included student portfolio, site preceptor evaluation and the college-based assessments. End of training and baseline results were compared to determine the effectiveness of CBT in terms of improvement of skills. Problems were identified and action plans developed, to be implemented on the following cohort. Successful completion of CBT required a total score of 80%. The students who could not pass the assessment were given a chance to improve their weak competencies and retake the assessment. ResultsSince its implementation, five cohorts have been trained through CBT. Only 12% of interns passed the training in first attempt in the first cohort. This passing percentage dramatically increased to 75–100% in the consecutive cohorts where students scored better in the portfolio, and site preceptor evaluation as compared to the college-based assessment. Students’ feedback towards the assignments was positive. ConclusionParticipatory Action Research was found to be an effective approach towards developing a competency-based training program for Pharmacy interns. More FIP competencies and evaluation strategies will be added to the internship program in the future. Furthermore, a national approach towards implementation of CBT should be used to ensure the uniformity of competency of pharmacists across the kingdom.

Prevalence and factors associated with potential drug-drug interactions in prescriptions presented at private pharmacies in Mbarara city, southwestern Uganda.

Drug-drug interactions (DDIs) influence the effectiveness of medication and thus determine the treatment outcomes of diseases managed with pharmacotherapy. This study aimed to determine the prevalence, severity, and factors associated with potential drug-drug interactions in prescriptions presented at private pharmacies in Mbarara city. DDIs were identified and classified basing on risk and severity using Lexicomp drug interaction database. STATA version 13 was used to analyze the collected data. Descriptive statistics were used to summarize the severity of potential DDIs identified. Bivariate and multivariate logistic regression was employed to identify different factors associated with the presence of potential DDIs. A total of 295 prescriptions from 18 private pharmacies were studied and the prevalence of clinically significant potential DDIs was 37.6%. About half (149, 50.5%) of the patients were females, the majority (199, 67.5%) were adults 18-59 years of age whereas most (208, 70.5%) had a comorbid condition. Over one half (162, 54.9%) of the prescriptions were received from hospitals and majority of the prescriptions had 4 drugs prescribed (n= 175, 59.32%). Having one or more comorbidities and prescribing of therapeutic drug categories including anti-fungal, antihypertensives, analgesics, or corticosteroids were significantly associated with potential DDIs. The prevalence of potential drug-drug interactions in outpatient setting in Mbarara city was high and majority of the potential DDIs were of moderate severity. Having 1 or more comorbidities and prescribing of therapeutic drug categories including antifungals, antihypertensives, analgesics, or corticosteroids were significantly associated with potential DDIs.

Financial hardship of tuberculosis patients registered under National Tuberculosis Elimination Programme (NTEP) in rural India: A longitudinal study

BackgroundIndia shares a significant proportion of the Tuberculosis (TB) burden of the world. TB diagnosis, treatment, and success are complicated by the chronic nature of the disease as well as additional stressors including financial, psychological, and social hardships, adverse events associated with management, and poor compliance towards anti-tuberculosis medications. MethodsThis is a longitudinal study conducted in the Tuberculosis Units (TUs) of rural field practice areas of the Department of Community Medicine and Family Medicine in a tertiary care hospital in Odisha. 168 diagnosed TB patients from the TUs were enrolled after registration in NTEP and were followed up every month for 6 months or treatment completion. TB patient's cost estimate tool was used to collect data regarding the cost incurred by the patients before and during the diagnosis as well as in the post-diagnosis or treatment period. Results and conclusionOut-of-pocket expenditure was calculated as direct, indirect, and total cost in the pre and post-diagnostic phases of the disease. The median pre and post-diagnosis direct, indirect and total costs were ₹ 12,805, ₹ 16,960 and ₹ 31,192, respectively, with almost 62 % of participants spending more than 20 % of their annual income. In this study, 41 % of participants had to stop working for more than 60 days, and 53.1 % faced distress financing due to the disease. Through this study, we found that more than half of rural TB patients still visit private health facilities, and 20 % start anti-TB drugs by purchasing them from private pharmacies, which incur substantial out-of-pocket expenditure. Most participants faced catastrophic costs associated with hospitalisation, lower family income, and a delay in disease diagnosis.

The impact of inflation on medicine prices in Nigeria: a comparative analysis of public and private pharmacies

The impact of inflation on medicine prices in Nigeria: a comparative analysis of public and private pharmacies

Antibiotics Self-remedy Use among Health and Nonhealth Undergraduate Students: An Application of the Theory of Planned Behavior

Objectives: In this study we examined students’ sources of antibiotic drugs and information used for antibioticself-remedy and assessed the relationships between demographic characteristics and self-remedy withusing antibiotic drugs (SRUAD). We also assessed the correlations between SRUAD and Theory of PlannedBehavior (TPB) concepts. Finally, we assessed differences among TPB concepts for students who use or donot use antibiotics as self-remedy. Methods: A cross-sectional correlation study was conducted among 920students. A validated questionnaire “Antibiotics Self-remedy Use based on TPB” was used to gather data onantibiotic self-remedy practices. We surveyed undergraduate students from various academic disciplines ata public university, excluding graduate students and those undergraduate students who participated in thepilot study, to explore their experiences and perceptions in their early stages of higher education, focusingon their unique perspectives. We calculated descriptive statistics, chi-square, correlations, and independentt-test. Results: Most participants (67.6%) used antibiotic self-remedy, with private pharmacies being theprimary source. Students primarily used prescriptions and personal experiences. SRUAD was more prevalentamong health/medical students, with attitude and perceived behavioral control significantly influencingSRUAD use. Conclusion: The development of health education interventions should consider attitudes andperceived behavioral control towards antibiotic self-remedy among students to limit SRUAD in their society.

Galenic Laboratory: State of the Art-A Scientific and Technological Discipline, Innovation and Management

The term galenic imply a scientific and technical matter but also an art. Related the hospital practice the future of pharmacy pass though the innovation of the galenic lab. Observing the today hospital practice HP in many countries and the international literature involved it is clear how clinical pharmacy is linked to the galenic lab practice LP. Today more than recent past due to the various kinds of magistral formula requested by the clinicians It is necessary that the clinical pharmacist CP perspective must to be added to the classic galenic lab competencies: this make possible to complete the profile of efficacy and safety of this fundamental and crucial Drugs like the magistral formula and officinal and their use. Aim of this ancient discipline and art is today to provide efficacy and safe drugs for the need of single patient when it is not possible to use the industrial product. The clinical galenic activity can be divided into sterile and non-sterile. (Total parenteral nutrition TPN bags, Pain therapy, oncological parenteral drugs lab UFA, radio drugs and diagnostics and non-sterile galenics).Aim of this work is to deeply investigate this relevant link (Clinical Pharmacy CP with Lab Practice LP) in order to get the really best clinical results for the patients and healthcare org need. Clinical pharmacy CP principle, Pharmaceutical care PC, the managerial competencies and personalized pharmacy added to the best knowledge and competencies in the galenic lab. Make the difference in order to obtain the right final clinical results. The same in this work are submitted to the international pharmacy practitioner, directors, researcher or students the Normative rules operating in an advanced country like Italy: the simplified NBP (NORME DI BUONA PREPARAZIONE), example that can be applied also in the non-advanced nations. In Italy pharmacist can follow or the full NBP (NORME DI BUONA PREPARAZIONE) rules of the official pharmacopeia or the simplified according DM Salute 18.nov.2003. (Related the kind of galenic formula prepared if sterile or not). The NBP (NORME DI BUONA PREPARAZIONE) (good manufacturing rules) introduce a QUALITY CQ SYSTEM MANAGEMENT. The full NBP (NORME DI BUONA PREPARAZIONE) are more used in more complex labs in ex. involved in specialist products (Like oncologic or radio drugs, sterile colliria and other). These rules guarantee the quality, security and the efficacy of a drug prepared in galenic lab. These are based on the responsibility principles, plan, and documentation of all activity. (QUALITY SYSTEM OF INSURANCE CQ). All the phases of the preparation are under the responsibility of the pharmacist. The final quality of the products depends on the correct use of API and excipients, on the right calculations operation, right volume measure or weight operation and the Check on the final products: -following of the procedure, aspects, pakaging and closing system and other request by ITALIAN FU related the specific pharmaceutical form. According NBP (NORME DI BUONA PREPARAZIONE) the lab. Must to be separated (or it must to be separable) form the rest of pharmacy and a second pharmacist (that is different form the pharmacist that prepare) must to check the final preparation. The locals must to be according strictly environmental condition required normative rules by to make possible to prepare in safety way drugs. And it is mandatory to follow the written procedure: instrument verify, training of the pharmacists Cleaning procedure, significations. For Raw materials: it is needed to have certifications, technical sheet, safety sheet, data of the first use, expiry data Working sheet is mandatory to testify the operations. The pharmacist can follow this 2 option related the kind of drugs produced and the characteristic of the lab. It is not the main focus of this work to produce a literal translation of the DM 18/nov /2003 only to submit its general meanings. This can be considered for the authors useful to be added also to the normative rules in force in other non-advanced countries. In order to make more interesting this book some useful concepts of physiology of the stomach and GI tract are reported. The same relevant pharmaceutical concepts and technique with a focus on the capsules CPS as pharmaceutical form (gastro resistance, delayed release), some oral suspension, gels and other few preparation. This work is produced whit a non-conventional approach: it is not a book of pharmaceutical technique. Innovation and management of the system make possible to increase the power of the galenic laboratories In the hospital or in private pharmacy. This work is produced only for international purpose.

Prevalence and determinants of household medicine storage in Vietnam: A community-based cross-sectional study.

The COVID-19 pandemic has significantly impacted individual health, potentially increasing the demand for home medicine storage. However, inappropriate household medicine storage can lead to drug waste and unnecessary hazards. This study aimed to explore the prevalence of and identify the factors that predict medicine storage in Vietnamese households. A community-based cross-sectional study was conducted with 800 households in Danang, Vietnam. A multi-stage sampling method was applied in this study. The data collection tool was modified from previous studies and consisted of three sections: household head characteristics, household characteristics, and medicine storage practice. Bivariable and multivariable binary logistic regression analyses were used to identify the factors influencing medicine storage at a p-value of less than 0.05. Among 800 households surveyed, 71.6% stored medicine. Analgesics-antipyretics were the most common type of medicine stored (80.8%). 90.1% of households obtained their medicines from private pharmacies, 68.1% of households stored medicine for future use and 58.8% had a home medicine cabinet. 9.4% of households did not store medicine in the appropriate packaging and 19.4% of households did not check the expiry date of their medicine. Educational level (AOR = 2.74; 95% CI = 1.84-4.06), income (AOR = 11.38; 95% CI = 1.46-88.79), presence of chronic illnesses (AOR = 12.44; 95% CI = 7.20-21.21), presence of children (AOR = 2.36; 95% CI = 1.56-3.58), presence of healthcare professionals (AOR = 2.14; 95% CI = 1.28-3.56) were predictors of the medicine storage. The current study found a high prevalence of household medication storage and some inappropriate storage behaviors. Therefore, attention should be given to develop effective interventions and policies to promote safe and appropriate storage practices.

Patient Care Indicators Related To Drug Dispensing At Public and Private Pharmacies In Thatta Sindh, Pakistan: A Cross Sectional Study

Patient Care Indicators Related To Drug Dispensing At Public and Private Pharmacies In Thatta Sindh, Pakistan: A Cross Sectional Study

Availability, price and affordability of insulin, delivery devices and self-monitoring blood glucose devices in Indonesia.

Insulin is essential for the survival of people with type 1 diabetes and for better management of people with type 2 diabetes. People with diabetes using insulin also require self-monitoring blood glucose (SMBG) devices (e.g., meters, strips, continuous monitoring systems) for day-to-day management. It is essential to ensure that insulin and these devices are available and affordable. This study aimed to evaluate the availability, price, and affordability of insulin and SMBG devices in Indonesia using an adaptation of the World Health Organization/Health Action International (WHO/HAI) price survey. A total of 34 public health facilities (hospitals, primary healthcare centres/Puskesmas) and 37 private pharmacies were sampled. Information from three major online marketplaces was also collected. Prices were expressed as median patient prices (US$). Affordability was defined as the number of days' wages needed by the lowest paid unskilled government worker (LPGW) to purchase 30 days' supply of insulin, delivery devices and SMBGs. Availability of analogue insulin was slightly higher in public facilities (63.6%) than in the private sector (43.2%), with no human insulin available in both sectors. Conversely, better availability was observed in private facilities for SMBG devices as public sector facilities did not supply devices for self-testing. Median prices for 1000IU analogues varied between the public sector (US$ 5.26) and the private sector (US$11.24). The highest median price of analogues was seen in online marketplaces (US$ 28.65). The least costly median price of SMBG devices were observed in online platforms (meter: US$ 18.37, test strip: US$ 0.27, lancet: US$ 0.02). A low-income person had to work 2-3 days to buy 1000IU of analogues. It required 5-7 days' and 4-5 day's wages to purchase a meter and a month's supply of test strips, respectively. The availability and affordability of insulin and SMBG devices remain important issues in Indonesia requiring holistic approaches for further improvement.

Assessment of prices, availability and affordability of essential medicines in Juba County, South Sudan

BackgroundAccess to safe, effective, affordable, and high-quality medications has been included in the Sustainable Development Goals (SDGs) of the United Nations as a crucial step towards attaining universal health coverage. Access to medicines is a fundamental human right. If medicines are accessible and affordable, they save lives by reducing mortality and morbidity associated with acute and chronic diseases. WHO recommends that all countries voluntarily reach the minimum target of 80% availability of medicines by 2025. The primary purpose of this research is to assess access to essential medicines in Juba County, South Sudan.MethodsThis study was undertaken using the standard World Health Organization/Health Action International Organization (WHO/HAI) approach for surveying the prices, availability, and affordability of medicines. A survey was conducted in six payams of Juba County, South Sudan, and 55 health facilities were assessed.ResultsPrices for generic medicines were better in faith-based health facilities with a median price ratio of 1.95. Private pharmacies and private clinics had MPRs of 4.64 and 4.32, respectively. Local prices were high compared to International referent prices. Availability of medicines was highest in the faith-based health facilities (65.5%) and slightly lower in private pharmacies (55.4%), private clinics (57.7%) and public (50.4%) sectors. Most of the surveyed medicines were unaffordable. The medicines needed to treat non-communicable diseases cost up to 33.7-day wages for one full course of treatment.ConclusionsIn South Sudan, medicines are poorly available in all sectors. Medicines are affordable in the public sector but Most medicines are unaffordable in private pharmacies, private clinics and faith-based health facilities. Poor medicines availability in the public sector contributes to the overall unaffordability of medicines in all the other sectors.

A qualitative study of pharmacists' perceptions and awareness of homoeopathic medicines in Durban, South Africa.

There is growing interest in the demand for and use of homoeopathic medicines by the public; however, little is known about the perspectives of pharmacists regarding the use of these medicines, particularly in the South African private health context. A qualitative approach using an exploratory cross-sectional descriptive design was used. Data were collected from a purposive sample of 15 participants comprising pharmacy managers, pharmacists and pharmacy assistants from six different conveniently selected private pharmacy retail outlets. Data were collected using individual interviews utilising a semi-structured interview guide. An audiotape was used to record the data which were transcribed verbatim and analysed thematically, following Tech's steps of data analysis. Ethical approval to conduct the study was obtained from the Durban University of Technology's Institutional Research Ethics Committee. The findings of this study revealed four superordinate themes related to pharmacists' perceptions and self-reported awareness regarding homoeopathic medicines. These are (1) negative perceptions regarding homoeopathic medicines, (2) perceived benefits of homoeopathic medicines, (3) poor knowledge and awareness of homoeopathic medicines and (4) capacity development and curriculum aspects. The findings highlight the need for an educational intervention on homoeopathic medicines targeting pre-service and in-service pharmacy practitioners, to enable them to provide effective education regarding all types of medicines as the demand for homoeopathic medicines increases.Contribution:The study findings provide evidence to support advocacy for an educational intervention to improve awareness and knowledge of pharmacists to enable provision of effective health education for patients. More research, however, is required to inform the contents of this training intervention for pharmacists.