MyMedR

Displaying all 2 publications

Abstract:

Sort:

Fulltext Antibiotics dispensing for URTIs by community pharmacists (CPs) and general medical practitioners in Penang, Malaysia: A comparative study using simulated patients (SPs)

Alabid AH, Ibrahim MI, Hassali MA

J Clin Diagn Res, 2014 Jan;8(1):119-23.
PMID: 24596741 DOI: 10.7860/JCDR/2014/6199.3923

BACKGROUND: In Malaysia, doctors in private clinics (often called dispensing doctors) are permitted to dispense medicines. This potentially may compromise rational dispensing of medicines in general and antibiotics in particular.
AIM: This study explored, assessed and compared dispensing of antibiotics between Community Pharmacist (CP) and General Practitioners (GPs) regarding symptomatic diagnosis, antibiotic categories, adherence to therapeutic doses and promotion of generic antibiotics.
METHOD: The study used trained Simulated Patients (SPs), who used a scenario of common cold symptoms at GP private clinics and community pharmacies to observe and explore the practice of antibiotics dispensing. The study was conducted within the period of May to September 2011 in Penang, Malaysia. The data was analysed using descriptive statistics, Chi-square and Fisher's Exact Tests at alpha level of 0.05.
RESULTS: GPs dispensed more antibiotics than CPs (p= 0.001) for common cold symptoms. They dispensed more Amoxicillin (n = 14, 35%) than CPs (n = 11, 11%) (p < 0.001) and more Tetracycline (n = 3, 7.5%) while no CP dispensed this category (p = 0.022). On the other hand, CPs (n = 11, 11%) suggested brand antibiotics where as GPs dispensed only generic antibiotics (p < 0.001). Generally GPs comply better with the symptomatic diagnosis standard e.g. when asking SPs about the symptoms they had, all GPs (n = 40, 100%) complied better with this standard. Despite that, they dispensed more antibiotics (n = 26, 65%) than CPs (n = 29, 29%) (p = 0.001). GPs (n = 22, 55%) also are better than CPs (n = 16, 16%) in adherence to therapeutic doses (p< 0.001).
CONCLUSION: Findings showed poor adherence to rational dispensing of antibiotics by both providers. Although, GPs adhere better to symptomatic diagnosis and therapeutic dosing of antibiotics than CPs, they unnecessarily prescribe and dispense more antibiotics for Upper respiratory tract infection (URTI) symptoms. Establishing prescription guidance and regulatory actions, especially for URTIs treatment, and separating of medication dispensing are seemed to be crucial steps for the reform.
KEYWORDS: Community pharmacists; Dispensing doctors; Dispensing separation; General practitioners; Simulated patients ligament
Fulltext Do Professional Practices among Malaysian Private Healthcare Providers Differ? A Comparative Study using Simulated Patients

Alabid AH, Ibrahim MI, Hassali MA

J Clin Diagn Res, 2013 Dec;7(12):2912-6.
PMID: 24551673 DOI: 10.7860/JCDR/2013/6198.3789

BACKGROUND: Malaysia, a South East Asian country, legally permits general medical practitioners in private clinics to dispense medicines. This possibly can dilute the pharmacist role in the provision of healthcare and pharmaceutical care and deprive patients to benefit from these services.
OBJECTIVE: This study explored, assessed and compared the current status of medicines labeling, patient's counseling, and symptomatic diagnosis by general practitioners and community pharmacists.
MATERIAL AND METHODS: This study used trained Simulated Patients (SP), who participated in a scenario of common cold symptoms at private clinics and community pharmacies. SPs explored medication labeling, patients counseling and symptomatic diagnosis undertaken by general practitioners and community pharmacists. Later, study authors assessed and compared these practices. The study was conducted during June 2011 in Penang, Malaysia.
RESULTS: The study used descriptive statistics and Fisher-exact test to analyze data. Regarding patients counseling standard, among 100 visits by simulated patients, 64 (64%) from community pharmacists provided information about the medicine name, its indication, dosage and route of administration versus 17 (42.5%) general practitioners during 40 visits (p=0.024). Concerning adherence to labeling standard, for instance, only in one pharmacy visit, (1%) the pharmacist wrote the name of the patient on the medication label versus in 32 (80%) of doctors' visits, the doctors adhered to this labeling standard (p<0.001). In all doctors' visits (n=40, 100%), SPs were asked about symptoms, whereas in 87 (87%) CPs' visits, pharmacists fulfilled this counseling standard (p=0.02).
CONCLUSION: Although pharmacists showed less compliance to medicine labeling and symptomatic diagnosis compared to doctors, their counseling of patients was better. Separation will definitely contribute to more concentration of each provider on his/her roles and improve and direct the experiences and skills towards being more patient oriented.

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links