Skills and practices of pharmacy staff for dispensing of drugs with fiscalized substances in drugstores and pharmacies
DOI:
https://doi.org/10.11606/s1518-8787.2021055003103Palavras-chave:
Tramadol, supply & distribution, Good Dispensing Practices, Professional-Patient Relations, Education, Pharmacy, Drugstores, Pharmacy staff, Fiscalized SubstancesResumo
OBJETIVE To evaluate the skills and practices of pharmacy staff during the dispensing of tramadol (drug with fiscalized substance) in drugstores and pharmacies in Medellin, Colombia. METHODS A cross-sectional study was performed. The simulated patient technique was used. The main outcomes included the information provided on the dispensed drug (tramadol), the use of tools to provide information, and the information provided on drug precautions and use recommendations. RESULTS We visited 305 drugstores and pharmacies. The average dispensing time was 2.3 min (SD 1.1 min). In nine drugstores and pharmacies (3.0%), tramadol was not dispensed because it was not in stock. In 17 drugstores and pharmacies (5.7%), the simulated patients were actively informed by the dispensing pharmacy staff; of these, 16 provided oral information and one provided oral and written information. Eight patients (2.7%) received information regarding tramadol use. However, 99% of patients were not informed about tramadol side effects such as dependence, sedation, or hypnosis, and none of the simulated female patients were informed on the precautions related to tramadol use during pregnancy or lactation. CONCLUSIONS Communication skills and appropriate practices of pharmacy staff are critical to patient self-care. However, this study shows their difficulty in counseling about precautions and use recommendations of drugs with fiscalized substances. These outcomes could inform future studies focusing on the rational use of these drugs in drugstores and pharmacies. It is necessary to improve the pharmacy staff competencies through continuing education programs, to facilitate access to information and training.
Referências
Colegio Nacional de Quimicos Farmaceuticos (COL). Servicio Nacional de Aprendizage – SENA, Dirección General. Caracterización ocupacional del sector farmacéutico en Colombia, enfoque por entornos. Bogotá (COL): SENA; 2008 [cited 2018 Jun 1]. Available from: http://repositorio.sena.edu.co/handle/11404/2142 [ Links ]
International Pharmaceutical Federation; World Health Organization. Joint Guidelines on good practices in Pharmacy: standards for the quality of pharmaceutical services. The Hague (NLD): FIP/WHO; 2011 [cited 2018 Oct 1]. Available from: https://www.fip.org/files/fip/WHO/GPP%2520guidelines%2520FIP%2520publication_final.pdf [ Links ]
Nkansah N, Mostovetsky O, Yu C, Chheng T, Beney J, Bond CM, et al. Effect of outpatient pharmacists’ non-dispensing roles on patient outcomes and prescribing patterns. Cochrane Database Syst Rev. 2010;(7):CD000336. https://doi.org/10.1002/14651858.CD000336.pub2 [ Links ]
Ministerio de Salud y Protección Social (COL). Decreto Nº 780 de 6 de mayo de 2016. Por medio del cual se expide el Decreto Único Reglamentario del Sector Salud y Protección Social. Bogotá (COL); 2016. [ Links ]
Gokcekus L, Toklu HZ, Demirdamar R, Gumusel B. Dispensing practice in the community pharmacies in the Turkish Republic of Northern Cyprus. Int J Clin Pharm. 2012;34(2):312-24. https://doi.org/10.1007/s11096-011-9605-z [ Links ]
Martí-Gil C, Barreda-Hernández D, Marcos-Pérez G, Barreira-Hernández D. [Counseling: a tool for enhancing the communication with the patient]. Farm Hosp. 2013;37(3):236-9. Spanish. https://doi.org/10.7399/FH.2013.37.3.559 [ Links ]
Farcas A, Sinpetrean A, Mogosan C, Palage M, Vostinaru O, Bojita M, Dumitrascu D, et al. Adverse drug reactions detected by stimulated spontaneous reporting in an internal medicine department in Romania. Eur J Intern Med. 2010;21(5):453-7. https://doi.org/10.1016/j.ejim.2010.05.014 [ Links ]
Wu TY, Jen MH, Bottle A, Molokhia M, Aylin P, Bell D, et al. Ten-year trends in hospital admissions for adverse drug reactions in England 1999-2009. J R Soc Med. 2010;103(6):239-50. https://doi.org/10.1258/jrsm.2010.100113 [ Links ]
World Health Organization. Ensuring the balance in national policies on controlled substances: guidance for availability and accessibility of controlled medicines. Geneva (CH): WHO; 2012 [cited 2017 Aug 29]. Available from: https://apps.who.int/iris/handle/10665/44519 [ Links ]
Alshammari TM, Alhindi SA, Alrashdi AM, Benmerzouga I, Aljofan M. Pharmacy Malpractice: the rate and prevalence of dispensing high-risk prescription-only medications at community pharmacies in Saudi Arabia. Saudi Pharm J. 2017;25(5):709-14. https://doi.org/10.1016/j.jsps.2016.10.001 [ Links ]
Ceballos M, Giraldo JA, Marín VH, Amariles P. Characterization of aspects related to the use of controlled drugs in drugstores and pharmacies-drugstores in Medellin and the Metropolitan Area. Rev Univ Ind Santander Salud. 2018;50(1):27-36. https://doi.org/10.18273/revsal.v50n1-2018003 [ Links ]
Berger K, Eickhoff C, Schulz M. Counselling quality in community pharmacies: implementation of the pseudo customer methodology in Germany. J Clin Pharm Ther. 2005;30(1):45-57. https://doi.org/10.1111/j.1365-2710.2004.00611.x [ Links ]
Watson MC, Cleland JA, Bond CM. Simulated patient visits with immediate feedback to improve the supply of over-the-counter medicines: a feasibility study. Fam Pract. 2009;26(6):532-42. https://doi.org/10.1093/fampra/cmp061 [ Links ]
Xu T, Almeida Neto AC, Moles RJ. A systematic review of simulated-patient methods used in community pharmacy to assess the provision of non-prescription medicines. Int J Pharm Pract. 2012;20(5):307-19. https://doi.org/10.1111/j.2042-7174.2012.00201.x [ Links ]
Sarkar S, Nebhinani N, Singh SM, Mattoo SK, Basu D. Tramadol dependence: a case series from India. Indian J Psychol Med. 2012;34(3):283-5. https://doi.org/10.4103/0253-7176.106038 [ Links ]
Soyka M, Backmund M, Hasemann S. Tramadol use and dependence in chronic noncancer pain patients. Pharmacopsychiatry. 2004;37(4):191-2. https://doi.org/10.1055/s-2004-827177 [ Links ]
Sweileh WM, Shraim NY, Zyoud SH, Al-Jabi SW. Worldwide research productivity on tramadol: a bibliometric analysis. Springerplus. 2016;5(1):1108. https://doi.org/10.1186/s40064-016-2801-5 [ Links ]
Management Science for Health. MDS-3: Managing Access to Medicines and other Health Technologies. Chapter 30: Ensuring good dispensing practices. Part II: Pharmaceutical Management. Arlington, VA. 2012. Available from: https://www.msh.org/resources/mds-3-managing-access-to-medicines-and-health-technologies [ Links ]
Awad AI, Himad HA. Drug-use practices in teaching hospitals of Khartoum State, Sudan. Eur J Clin Pharmacol. 2006;62(12):1087-93. https://doi.org/10.1007/s00228-006-0216-x [ Links ]
Hogerzeil HV, Bimo MD, Ross-Degnan D, Laing RO, Ofori-Adjei D, Santoso B, et al. Field tests for rational drug use in twelve developing countries. Lancet. 1993;342(8884):1408-10. https://doi.org/10.1016/0140-6736(93)92760-Q [ Links ]
Naves JOS, Silver LD. Evaluation of pharmaceutical assistance in public primary care in Brasilia, Brazil. Rev Saude Publica. 2005;39(2):223-30. https://doi.org/10.1590/S0034-89102005000200013 [ Links ]
Diwan V, Sabde YD, Byström E, De Costa A. Treatment of pediatric diarrhea: a simulated client study at private pharmacies of Ujjain, Madhya Pradesh, India. J Infect Dev Ctries. 2015;9(5):505-11. https://doi.org/10.3855/jidc.5694 [ Links ]
Pham DM, Byrkit M, Pham HV, Pham T, Nguyen CT. Improving pharmacy staff knowledge and practice on childhood diarrhea management in Vietnam: are educational interventions effective? PLoS One. 2013;8(10):e74882. https://doi.org/10.1371/journal.pone.0074882 [ Links ]
Dabaghzadeh F, Hajjari R. Practice of community pharmacists related to multivitamin supplements: a simulated patient study in Iran. Int J Clin Pharm. 2018;40(1):190-5. https://doi.org/10.1007/s11096-017-0579-3 [ Links ]
Santos V, Nitrini SMOO. Prescription and patient-care indicators in healthcare services. Rev Saude Publica. 2004;38(6):819-26. https://doi.org/10.1590/s0034-89102004000600010 [ Links ]
WHO International Working Group for Drug Statistics Methodology, WHO Collaborative Centre for Drug Statistics Methodology, WHO Collaborating Centre for Drug Utilization Research and Clinical Pharmacological Services. Introduction to drug utilization research. Geneva (CH); 2003 [cited 2018 Oct 1]. Available from: https://apps.who.int/iris/handle/10665/42627 [ Links ]
Beakley BD, Kaye AM, Kaye AD. Tramadol, pharmacology, side effects, and serotonin syndrome: a review. Pain Physician. 2015;18(4):395-400. https://doi.org/10.36076/ppj.2015/18/395 [ Links ]
Miotto K, Cho AK, Khalil MA, Blanco K, Sasaki JD, Rawson R. Trends in Tramadol: pharmacology, metabolism, and misuse. Anesth Analg. 2017;124(1):44-51. https://doi.org/10.1213/ANE.0000000000001683 [ Links ]
Toklu HZ, Akici A, Oktay Ş, Cali S, Sezen SF, Keyer-Uysal M. The pharmacy practice of community pharmacists in Turkey. Marmara Pharm J. 2010;1(14):53-60. https://doi.org/10.12991/201014464 [ Links ]
Toklu HZ, Dülger GA, Hıdıroğlu S, Akici A, Yetim A, Gannemoglu, et al. Knowledge and attitudes of the pharmacists, prescribers and patients towards generic drug use in Istanbul - Turkey. Pharm Pract (Granada). 2012;10(4):199-206. https://doi.org/10.4321/S1886-36552012000400004 [ Links ]
Caamaño F, Tomé-Otero M, Takkouche B, Gestal-Otero JJ. Influence of pharmacists’ opinions on their dispensing medicines without requirement of a doctor’s prescription. Gac Sanit. 2005;19(1):9-14. https://doi.org/10.1157/13071811 [ Links ]
International Pharmaceutical Federation. Pharmacy Education Taskforce: a global competency framework. Version 1. The Hague (NLD); FIP; 2012 [cited 2018 Jun 22]. Available from: https://www.fip.org/files/fip/PharmacyEducation/GbCF_v1.pdf [ Links ]
Vacca CP, Niño CY, Reveiz L. [Restriction of antibiotic sales in pharmacies in Bogotá, Colombia: a descriptive study]. Rev Panam Salud Publica. 2011;30(6):586-91. Spanish. [ Links ]
Buxton JA, Babbitt RM, Clegg CA, Durley SF, Epplen KT, Marsden LM, et al. ASHP guidelines: minimum standard for ambulatory care pharmacy practice. Am J Health Syst Pharm. 2015;72(14):1221-36. https://doi.org/10.2146/sp150005 [ Links ]
Scahill SL, Atif M, Babar ZU. Defining pharmacy and its practice: a conceptual model for an international audience. Integr Pharm Res Pract. 2017;6:121-9. https://doi.org/10.2147/IPRP.S124866 [ Links ]
Ceballos M, Salazar-Ospina A, Sabater-Hernández D, Amariles P. Evaluation of the effects of a drug with fiscalized substance dispensation, health education, and pharmacovigilance continuing education program in Colombia drugstores and drugstores/pharmacies: study protocol of a multicenter, cluster-randomized controlled. Trials. 2020;21(1):545. https://doi.org/10.1186/s13063-020-04481-1 [ Links ]
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Copyright (c) 2021 Mauricio Ceballos, Yaqueline Llano, Andrea Salazar-Ospina, Juliana Madrigal-Cadavid, Daniel Pino-Marín, Pedro Amariles
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
