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Management of acute respiratory infections in drug shops and private pharmacies in Uganda: a study of counter attendants' knowledge and reported behaviour.
East Afr Med J. 2004 Feb; Suppl:S33-40.EA

Abstract

BACKGROUND

In Uganda, private pharmacies and drug shops are important sources of drugs for the majority of the population. In addition to selling drugs, these outlets often serve as primary sources of information about illness and drug therapy. However, the appropriateness of dispensing by staff in these drug outlets has been found to be suboptimal. Yet there has been no study documenting the determinants that underlie the dispensing pattern at these outlets. This study evaluated counter attendants' training background, their knowledge of acute respiratory infections (ARI), and their reported behaviour in the management of ARI in order to identify factors associated with dispensing behaviours.

STUDY DESIGN AND SETTING

This descriptive study was conducted in Kampala District, Uganda and used a cross-sectional survey research design to analyse the practice of 197 drug outlets including 28 pharmacies and 169 drug stores.

MAIN OUTCOME MEASURES

Counter attendants' training background; their knowledge of the causes, signs and symptoms of ARI; their perception of the dangers of ARI; and the drugs and advice offered for the management of mild and severe ARI.

RESULTS

Majority of the counter attendants had medical or pharmacy training. Most of them were nurses. The attendants' workload was generally low. High levels of self-medication among clients were reported at the outlets. Staff at a management level had low knowledge of the aetiology, signs and symptoms, and dangers of ARI. Prescribing an antibiotic was found to be the usual practice for managing ARI cases. Counter attendants at those outlets seldom gave advice or referrals for ARI cases. In particular, patient demand was a main barrier to appropriate dispensing. Strategies suggested by attendants for improving rational dispensing were to educate the public, provide training for the attendants, and re-enforce government supervision of drug outlets.

CONCLUSIONS

This study identified several self-reported inappropriate behaviours in the outlets. The formal training background and workload of counter attendants at drug shops and pharmacies were not found to be important contributors to irrational prescribing. The results of this study suggest that a combination of regulatory and educational interventions may yield to improvement in counter attendants' practices in private drug outlets.

Authors+Show Affiliations

Department of Pharmacology and Therapeutics, Faculty of Medicine, Makerere University, Kampala, Uganda.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15125114

Citation

Tumwikirize, W A., et al. "Management of Acute Respiratory Infections in Drug Shops and Private Pharmacies in Uganda: a Study of Counter Attendants' Knowledge and Reported Behaviour." East African Medical Journal, vol. Suppl, 2004, pp. S33-40.
Tumwikirize WA, Ekwaru PJ, Mohammed K, et al. Management of acute respiratory infections in drug shops and private pharmacies in Uganda: a study of counter attendants' knowledge and reported behaviour. East Afr Med J. 2004;Suppl:S33-40.
Tumwikirize, W. A., Ekwaru, P. J., Mohammed, K., Ogwal-Okeng, J. W., & Aupont, O. (2004). Management of acute respiratory infections in drug shops and private pharmacies in Uganda: a study of counter attendants' knowledge and reported behaviour. East African Medical Journal, Suppl, S33-40.
Tumwikirize WA, et al. Management of Acute Respiratory Infections in Drug Shops and Private Pharmacies in Uganda: a Study of Counter Attendants' Knowledge and Reported Behaviour. East Afr Med J. 2004;Suppl:S33-40. PubMed PMID: 15125114.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of acute respiratory infections in drug shops and private pharmacies in Uganda: a study of counter attendants' knowledge and reported behaviour. AU - Tumwikirize,W A, AU - Ekwaru,P J, AU - Mohammed,K, AU - Ogwal-Okeng,J W, AU - Aupont,O, PY - 2004/5/6/pubmed PY - 2004/5/22/medline PY - 2004/5/6/entrez SP - S33 EP - 40 JF - East African medical journal JO - East Afr Med J VL - Suppl N2 - BACKGROUND: In Uganda, private pharmacies and drug shops are important sources of drugs for the majority of the population. In addition to selling drugs, these outlets often serve as primary sources of information about illness and drug therapy. However, the appropriateness of dispensing by staff in these drug outlets has been found to be suboptimal. Yet there has been no study documenting the determinants that underlie the dispensing pattern at these outlets. This study evaluated counter attendants' training background, their knowledge of acute respiratory infections (ARI), and their reported behaviour in the management of ARI in order to identify factors associated with dispensing behaviours. STUDY DESIGN AND SETTING: This descriptive study was conducted in Kampala District, Uganda and used a cross-sectional survey research design to analyse the practice of 197 drug outlets including 28 pharmacies and 169 drug stores. MAIN OUTCOME MEASURES: Counter attendants' training background; their knowledge of the causes, signs and symptoms of ARI; their perception of the dangers of ARI; and the drugs and advice offered for the management of mild and severe ARI. RESULTS: Majority of the counter attendants had medical or pharmacy training. Most of them were nurses. The attendants' workload was generally low. High levels of self-medication among clients were reported at the outlets. Staff at a management level had low knowledge of the aetiology, signs and symptoms, and dangers of ARI. Prescribing an antibiotic was found to be the usual practice for managing ARI cases. Counter attendants at those outlets seldom gave advice or referrals for ARI cases. In particular, patient demand was a main barrier to appropriate dispensing. Strategies suggested by attendants for improving rational dispensing were to educate the public, provide training for the attendants, and re-enforce government supervision of drug outlets. CONCLUSIONS: This study identified several self-reported inappropriate behaviours in the outlets. The formal training background and workload of counter attendants at drug shops and pharmacies were not found to be important contributors to irrational prescribing. The results of this study suggest that a combination of regulatory and educational interventions may yield to improvement in counter attendants' practices in private drug outlets. SN - 0012-835X UR - https://www.unboundmedicine.com/medline/citation/15125114/Management_of_acute_respiratory_infections_in_drug_shops_and_private_pharmacies_in_Uganda:_a_study_of_counter_attendants'_knowledge_and_reported_behaviour_ DB - PRIME DP - Unbound Medicine ER -