1 role of dispensers in promoting rational drug use

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Role of Dispensers in Role of Dispensers in Promoting Rational Drug Promoting Rational Drug

UseUse

The Role of Dispensers in Promoting Rational Drug Use

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The Role of Dispensers in The Role of Dispensers in Promoting Rational Drug Use: Promoting Rational Drug Use: ObjectivesObjectives

• Identify who can be a dispenserIdentify who can be a dispenser

• Identify factors that influence Identify factors that influence dispensingdispensing

• Describe methods to enhance Describe methods to enhance dispenser-patient communicationsdispenser-patient communications

• Identify ways to influence a dispenser's Identify ways to influence a dispenser's behaviorbehavior


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Case ReportCase 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 4x250 mg daily for her tonsilitis. The patient eventually died two weeks after hospital admission.


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Who Are Dispensers?Who Are Dispensers?

• Pharmacists, pharmacy techniciansPharmacists, pharmacy technicians• Pharmacy assistantsPharmacy assistants• Nurses, nurse aidsNurses, nurse aids• DoctorsDoctors• Drug sellersDrug sellers• ShopkeepersShopkeepers• Taxi driversTaxi drivers• Family membersFamily members


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Prescriber and DispenserPrescriber and Dispenser

In the real world of drug use (rational and In the real world of drug use (rational and irrational)— irrational)—

A PRESCRIBER IS—A PRESCRIBER IS—Anyone with a recommendation for Anyone with a recommendation for treatmenttreatment

A DISPENSER IS—A DISPENSER IS—Anyone who gives out a treatmentAnyone who gives out a treatment


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What Does a Dispenser Need?What Does a Dispenser Need?

• Knowledge/source of Knowledge/source of information:information:

• Skills:Skills:

• Others:Others:

• drug informationdrug information

• product informationproduct information

• consultationconsultation

• communication skillcommunication skill

• promotional/marketing techniquespromotional/marketing techniques

• supplysupply

• dispensing equipment dispensing equipment

• dispenser-prescriber relationshipdispenser-prescriber relationship

• status/role in the health care systemstatus/role in the health care system


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Dispensing ProcessDispensing Process

• Receive prescriptionReceive prescription• Interpret prescriptionInterpret prescription• Retrieve medication/ingredientsRetrieve medication/ingredients• Prepare and processPrepare and process• Communicate with patientCommunicate with patient• Ensure patient's understandingEnsure patient's understanding• Monitor compliance by patientMonitor compliance by patient• Keep recordsKeep records


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Potential Errors and ProblemsPotential Errors and Problems

• Wrong interpretation of prescription (or diagnosis)Wrong interpretation of prescription (or diagnosis)

• Retrieval of the wrong drug from stockRetrieval of the wrong drug from stock

• Wrong dosagesWrong dosages

• Inadequate packaging/labelingInadequate packaging/labeling

• Inaccurate counting, compoundingInaccurate counting, compounding

• Inadequate or nonexistent labelingInadequate or nonexistent labeling

• No knowledge of proper drug complianceNo knowledge of proper drug compliance

• Insufficient knowledge of the disease processInsufficient knowledge of the disease process

• Insufficient time to talk with patients about their drugsInsufficient time to talk with patients about their drugs

• Inability to communicate to patients about therapyInability to communicate to patients about therapy


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Assessing Dispensing Assessing Dispensing ConditionsConditions

• Dispensing point conditionsDispensing point conditions

• Dispensing time? Communication Dispensing time? Communication time?time?

• How often do errors occur?How often do errors occur?

• Who is responsible for dispensing?Who is responsible for dispensing?

• Dispensing training in country?Dispensing training in country?

• Salaries and wages for dispensers?Salaries and wages for dispensers?

• Dispensing packaging?Dispensing packaging?


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Roles of Prescriber/Physician in Roles of Prescriber/Physician in Promoting Rational Drug UsePromoting Rational Drug Use

• DiagnosisDiagnosis

• PrescribingPrescribing

• Drug InformationDrug Information


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Roles of Pharmacist/Dispenser in Roles of Pharmacist/Dispenser in Ensuring Rational Drug UseEnsuring Rational Drug Use

• ProcurementProcurement

• DistributionDistribution

• PrescribingPrescribing

• InformationInformation

• Additional roles:Additional roles:– Communication with Communication with

physicianphysician

– Treatment guidelinesTreatment guidelines

– Research on prescribing Research on prescribing and utilizationand utilization

– Consumer educationConsumer education


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Improving Patient Compliance Improving Patient Compliance with Therapywith Therapy

• Dispenser-patient Dispenser-patient communicationcommunication

• Packaging for Packaging for patient usepatient use

• LabelingLabeling• Written informationWritten information


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Dispenser-Patient Dispenser-Patient CommunicationCommunication

• Dispensers Dispensers communicate with communicate with patients how to patients how to take drugstake drugs

• Ensuring their Ensuring their understanding is understanding is very importantvery important


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Packaging for Patient UsePackaging for Patient Use


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LabelingLabeling


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Dispensing in the Public or Dispensing in the Public or Private SectorPrivate Sector

• Public Sector Public Sector – Cheap but long delays and frequent stock-Cheap but long delays and frequent stock-

outs outs – Generic drugsGeneric drugs

• Private SectorPrivate Sector– Expensive but convenientExpensive but convenient– Brand name drugsBrand name drugs


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InterventionsInterventions

• GhanaGhana– Poster interventionPoster intervention

• UgandaUganda– Field trainingField training

• Kenya and IndonesiaKenya and Indonesia– Private drug sellersPrivate drug sellers

• PhilippinesPhilippines– Discussions with Discussions with

drug-selling drug-selling storekeepersstorekeepers


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Sample Package InsertSample Package Insert


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ConclusionConclusion

• Dispensing is a critical part of drug useDispensing is a critical part of drug use

• Dispensing is often neglected in Dispensing is often neglected in training and EDP programstraining and EDP programs

• Interventions exist to improve Interventions exist to improve dispensingdispensing

• Patients benefit from better dispensingPatients benefit from better dispensing

1 role of dispensers in promoting rational drug use

Documents

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wrong drug

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dispensing packaging

hospital pharmacy

prescriber isanyone

dispenser need