Role of Dispensers in Promoting Rational Drug Use
- Slides: 19
Role of Dispensers in Promoting Rational Drug Use 1
The Role of Dispensers in Promoting Rational Drug Use: Objectives • Identify who can be a dispenser • Identify factors that influence dispensing • Describe methods to enhance dispenser-patient communications • Identify ways to influence a dispenser's behavior The Role of Dispensers in Promoting Rational 2
Case Report A female student, age 20, suffering from tonsilitis, was seen by a doctor in a 600 -bed hospital OPD. She obtained a drug from the hospital pharmacy and took it as instructed. She felt very weak after taking the drug. Three days later she became severely comatose and was admitted to the same hospital. She took chlorpropamide 250 mg four times a day. The OPD doctor claimed that he prescribed chloromycetine 4 x 250 mg daily for her tonsilitis. The patient eventually died two weeks after hospital admission. The Role of Dispensers in Promoting Rational 3
Who Are Dispensers? • • Pharmacists, pharmacy technicians Pharmacy assistants Nurses, nurse aids Doctors Drug sellers Shopkeepers Taxi drivers Family members The Role of Dispensers in Promoting Rational 4
Prescriber and Dispenser In the real world of drug use (rational and irrational)— A PRESCRIBER IS— Anyone with a recommendation for treatment A DISPENSER IS— Anyone who gives out a treatment The Role of Dispensers in Promoting Rational 5
What Does a Dispenser Need? • Knowledge/source of • information: • • drug information product information consultation • Skills: • • communication skill promotional/marketing techniques • Others: • • supply dispensing equipment dispenser-prescriber relationship status/role in the health care system The Role of Dispensers in Promoting Rational 6
Dispensing Process • • Receive prescription Interpret prescription Retrieve medication/ingredients Prepare and process Communicate with patient Ensure patient's understanding Monitor compliance by patient Keep records The Role of Dispensers in Promoting Rational 7
Potential Errors and Problems • Wrong interpretation of prescription (or diagnosis) • Retrieval of the wrong drug from stock • Wrong dosages • Inadequate packaging/labeling • Inaccurate counting, compounding • Inadequate or nonexistent labeling • No knowledge of proper drug compliance • Insufficient knowledge of the disease process • Insufficient time to talk with patients about their drugs • Inability to communicate to patients about therapy The Role of Dispensers in Promoting Rational 8
Assessing Dispensing Conditions • Dispensing point conditions • Dispensing time? Communication time? • How often do errors occur? • Who is responsible for dispensing? • Dispensing training in country? • Salaries and wages for dispensers? • Dispensing packaging? The Role of Dispensers in Promoting Rational 9
Roles of Prescriber/Physician in Promoting Rational Drug Use • Diagnosis • Prescribing • Drug Information The Role of Dispensers in Promoting Rational 10
Roles of Pharmacist/Dispenser in Ensuring Rational Drug Use • • • Procurement Distribution Prescribing Information Additional roles: – Communication with physician – Treatment guidelines – Research on prescribing and utilization – Consumer education The Role of Dispensers in Promoting Rational 11
Improving Patient Compliance with Therapy • Dispenser-patient communication • Packaging for patient use • Labeling • Written information The Role of Dispensers in Promoting Rational 12
Dispenser-Patient Communication • Dispensers communicate with patients how to take drugs • Ensuring their understanding is very important The Role of Dispensers in Promoting Rational 13
Packaging for Patient Use The Role of Dispensers in Promoting Rational 14
Labeling The Role of Dispensers in Promoting Rational 15
Dispensing in the Public or Private Sector • Public Sector – Cheap but long delays and frequent stockouts – Generic drugs • Private Sector – Expensive but convenient – Brand name drugs The Role of Dispensers in Promoting Rational 16
Interventions • Ghana – Poster intervention • Uganda – Field training • Kenya and Indonesia – Private drug sellers • Philippines – Discussions with drug-selling storekeepers The Role of Dispensers in Promoting Rational 17
Sample Package Insert The Role of Dispensers in Promoting Rational 18
Conclusion • Dispensing is a critical part of drug use • Dispensing is often neglected in training and EDP programs • Interventions exist to improve dispensing • Patients benefit from better dispensing The Role of Dispensers in Promoting Rational 19
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