Determinants of non-adherence to prescriptions for dispense antibiotics among pharmacy workers in Dar es salaam region

Abstract

In Tanzania, health care reforms and privatization have increased the availability of drugs for lay people through private pharmacies. The private provision of drugs has been shown to be associated with irrational use of substandard drugs quality and non compliance to drug regulations. However, there is limited information regarding adherence to prescription requirements among pharmacy workers in Dar es Salaam region. The aim of the study was to determine factors influencing prescription adherence among pharmacy workers in Dar es Salaam region. A cross sectional study was conducted in July 2009 among 165 pharmacy workers in Dar es Salaam region. Questionnaires were administered to assess pharmacy worker's knowledge about Prescription only Medicine (PoM) also to find out how they would manage a client requesting antibiotics without a prescription. A simulated client method was administered in order to measure the pharmacy worker's behaviour. Of the 165 respondents interviewed, 87.9% were females and 57% were in the age group of 20-29 years. In this study, we also had a total of 62 encounters as simulated clients among whom 72.6% were handled by female pharmacy workers. During interview, 92.7% of pharmacy workers reported that•they would request for a prescription before dispensing any antibiotics. However, in 62 simulations of a patient with diarrhea at home 87.1 % (54/62) pharmacy workers did not ask for a prescription. Although among the 54 simulations a prescription was not requested, 88.9% of the pharmacy workers agreed to dispense antibiotics. In response to the question "What is the major factor that influences a pharmacy worker to dispense antibiotics without a prescription? The major factor reported by more than a half (53%) of pharmacy workers was client demand. The study recommends that the community should be sensitized and warned on the consequences of self administration of Prescription only Medicine (PoM) and pharmacy I workers are strongly urged to perform 'their responsibility more competently and ethically.