Improving private pharmacy practice

Chúc, Nguyễn Thị Kim; Larsson, Mattias; Nguyen, Thao Thi; Diwan, Vinod; Tomson, Göran; Falkenberg, Torkel

doi:10.1016/s0895-4356(02)00458-4

Cited by 83 publications

(56 citation statements)

References 21 publications

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“…Apart from the active involvement of the regulatory bodies and the long-arm of the law on drug smuggling and over- the-counter sells of prescription-only drugs, educational initiatives could be of practical significance to reduce the rates of emergence of drug resistant pathogens in the country. Educational programs were reported to be effective in improving the diagnostic qualities of health workers and reducing unjustified prescriptions [68]. Although information sources offer a framework to base educational intervention measures, a regular training is more effective than guidelines alone [69].…”

Section: Resultsmentioning

confidence: 99%

A meta-analysis of the proportion of antimicrobial resistant human Salmonella isolates in Ethiopia

Tadesse

2014

BMC Pharmacol Toxicol

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BackgroundAntimicrobial resistant Salmonella is a global problem and recently, a strain on the verge of pan-resistance was reported. In Ethiopia, the therapeutic management of Salmonellosis is difficult because drug sensitivity tests are not routinely carried out and treatment alternatives are not available in most health care facilities. The objectives of this study were to estimate the temporal changes and proportions of drug resistant isolates in Ethiopia.MethodsPublished studies on drug resistant Salmonella isolates were searched in Medline, Google Scholar and the lists of references of articles. Eligible studies were selected by using inclusion and exclusion criteria. Generic, methodological and statistical information were extracted from the eligible studies. The extracted data included the proportions of ampicillin, co-trimoxazole, chloramphenicol, ceftriaxone, ciprofloxacin and multi-drug resistant isolates. Pooled proportions were estimated by a random effects model.ResultsThe odds of multi-drug resistant isolates in the 2000s was higher than before the 1990s (OR =18.86, 95% CI = 13.08, 27.19). The pooled proportions of ampicillin, co-trimoxazole, chloramphenicol, ciprofloxacin and multi-drug resistant isolates in the 2000s were 86.01%, 68.01%, 62.08%, 3.61% and 79.56% respectively. S. Concord (>97%) was resistant to ampicillin, co-trimoxazole, chloramphenicol and ceftriaxone.ConclusionThe proportion of drug resistant isolates has increased since the 1970s. All drugs currently used for the treatment of Salmonellosis but ciprofloxacin are not reliable for an empirical therapy. Alternative drugs should be included in the essential drug list and measures should be taken to re-enforce the drug use policy.

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Section: Resultsmentioning

confidence: 99%

A meta-analysis of the proportion of antimicrobial resistant human Salmonella isolates in Ethiopia

Tadesse

2014

BMC Pharmacol Toxicol

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“…Their influence is reflected in the growing interest to include them in the provision of essential services, including treatment of malaria [1, 2], diarrhea [3], respiratory tract infections [4], and non-infectious diseases such as hypertension and dyslipidemia [5, 6]. The term ‘specialized drug shops’ refers to shops that sell medicines and related commodities [7].…”

Section: Introductionmentioning

confidence: 99%

The policy-practice gap: describing discordances between regulation on paper and real-life practices among specialized drug shops in Kenya

Wafula

Abuya

Amin³

et al. 2014

BMC Health Serv Res

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BackgroundSpecialized drug shops (SDSs) are popular in Sub-Saharan Africa because they provide convenient access to medicines. There is increasing interest in how policymakers can work with them, but little knowledge on how their operation relates to regulatory frameworks. This study sought to describe characteristics and predictors of regulatory practices among SDSs in Kenya.MethodsThe regulatory framework governing the Kenya pharmaceutical sector was mapped, and a list of regulations selected for inclusion in a survey questionnaire. An SDS census was conducted, and survey data collected from 213 SDSs from two districts in Western Kenya.ResultsThe majority of SDSs did not comply with regulations, with only 12% having a refrigerator and 22% having a separate dispensing area for instance. Additionally, less than half had at least one staff with pharmacy qualification (46%), with less than a third of all interviewed operators knowing the name of the law governing pharmacy.Regulatory infringement was more common among SDSs in rural locations; those that did not have staff with pharmacy qualifications; and those whose operator did not know the name of the pharmacy law. Compliance was not significantly associated with the frequency of inspections, with over 80% of both rural and urban SDSs reporting an inspection in the past year.ConclusionWhile compliance was low overall, it was particularly poor among SDSs operating in rural locations, and those that did not have staff with pharmacy qualification. This suggested the need for policy to introduce levels of practice in recognition of the variations in resource availability. Under such a system, rural SDSs operating in low-resource setting, and selling a limited range of medicines, may be exempted from certain regulatory requirements, as long as their scope of practice is limited to certain essential services only. Future research should also explore why regulatory compliance is poor despite regular inspections.

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“…We reviewed the 50 potential eligible articles for inclusion. Six of these studies met our inclusion criteria (Abuya 2009; Chalker 2002; Chalker 2005; Chuc 2002; Ross-Degnan 1996; Stenson 2001), and we excluded 39 for reasons given in the Characteristics of excluded studies. Five studies were identified after the review was submitted and are awaiting assessment (see Characteristics of studies awaiting classification).…”

Section: Resultsmentioning

confidence: 99%

“…Three included studies were cluster-randomised trials based on matched pairs of clusters (Chalker 2002; Chuc 2002; Stenson 2001). We did not re-analyse these data as matching cannot be taken into account in re-analyses in such studies unless the raw data are available.…”

Section: Methodsmentioning

confidence: 99%

Public stewardship of private for-profit healthcare providers in low- and middle-income countries

Wiysonge

Abdullahi

Ndze

et al. 2016

Cochrane Database of Systematic Reviews

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Background Governments use different approaches to ensure that private for‐profit healthcare services meet certain quality standards. Such government guidance, referred to as public stewardship, encompasses government policies, regulatory mechanisms, and implementation strategies for ensuring accountability in the delivery of services. However, the effectiveness of these strategies in low‐ and middle‐income countries (LMICs) have not been the subject of a systematic review. Objectives To assess the effects of public sector regulation, training, or co‐ordination of the private for‐profit health sector in low‐ and middle‐income countries. Search methods For related systematic reviews, we searched the Cochrane Database of Systematic Reviews (CDSR) 2015, Issue 4; Database of Abstracts of Reviews of Effectiveness (DARE) 2015, Issue 1; Health Technology Assessment Database (HTA) 2015, Issue 1; all part of The Cochrane Library , and searched 28 April 2015. For primary studies, we searched MEDLINE, Epub Ahead of Print, In‐Process & Other Non‐Indexed Citations, MEDLINE Daily and MEDLINE 1946 to Present, OvidSP (searched 16 June 2016); Science Citation Index and Social Sciences Citation Index 1987 to present, and Emerging Sources Citation Index 2015 to present, ISI Web of Science (searched 3 May 2016 for papers citing included studies); Cochrane Central Register of Controlled Trials (CENTRAL), 2015, Issue 3, part of The Cochrane Library (including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register) (searched 28 April 2015); Embase 1980 to 2015 Week 17, OvidSP (searched 28 April 2015); Global Health 1973 to 2015 Week 16, OvidSP (searched 30 April 2015); WHOLIS, WHO (searched 30 April 2015); Science Citation Index and Social Sciences Citation Index 1975 to present, ISI Web of Science (searched 30 April 2015); Health Management, ProQuest (searched 22 November 2013). In addition, in April 2016, we searched the reference lists of relevant articles, WHO International Clinical Trials Registry Platform, Clinicaltrials.gov, and various electronic databases of grey literature. Selection criteria Randomised trials, non‐randomised trials, interrupted time series studies, or controlled before‐after studies. Data collection and analysis Two authors independently assessed study eligibility and extracted data, comparing their results and resolving discrepancies by consensus. We expressed study results as risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI), where appropriate, and assessed the certainty of the evidence using Grades of Recommendation, Assessment, Development and Evaluation (GRADE). We did not conduct meta‐analysis because of heterogeneity of interventions and study designs. Main results We identified 20,177 records, 50 of them potentially eligible. W...

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Improving private pharmacy practice

Cited by 83 publications

References 21 publications

A meta-analysis of the proportion of antimicrobial resistant human Salmonella isolates in Ethiopia

A meta-analysis of the proportion of antimicrobial resistant human Salmonella isolates in Ethiopia

The policy-practice gap: describing discordances between regulation on paper and real-life practices among specialized drug shops in Kenya

Public stewardship of private for-profit healthcare providers in low- and middle-income countries

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