Rational use of medicine (RUM) for all medical conditions is crucial in attaining quality of healthcare and medical care for patients and the community as a whole. However, the actual medicine use pattern is not consistent with that of the World Health Organization (WHO) guideline and is often irrational in many healthcare setting, particularly in developing countries. Thus, the aim of the study was to evaluate rational medicine use based on WHO/International Network of Rational Use of Drugs (INRUD) core drug use indicators in Eritrean National and Regional Referral hospitals. A descriptive and cross-sectional approach was used to conduct the study. A sample of 4800 (600 from each hospital) outpatient prescriptions from all disciplines were systematically reviewed to assess the prescribing indicators. A total of 1600 (200 from each hospital) randomly selected patients were observed for patient indicators and all pharmacy personnel were interviewed to obtain the required information for facility-specific indicators. Data were collected using retrospective and prospective structured observational checklist between September and January, 2018. Descriptive statistics, Welch’s robust test of means and Duncan’s post hoc test were performed using IBM SPSS (version 22). The average number of medicines per prescription was 1.78 (SD = 0.79). Prescriptions that contained antibiotic and injectable were 54.50% and 6.60%, respectively. Besides, the percentage of medicines prescribed by generic name and from an essential medicine list (EML) was 98.86% and 94.73%, respectively. The overall average consultation and dispensing time were 5.46 minutes (SD = 3.86) and 36.49 seconds (SD = 46.83), respectively. Moreover, 87.32% of the prescribed medicines were actually dispensed. Only 68.24% of prescriptions were adequately labelled and 78.85% patients knew about the dosage of the medicine(s) in their prescriptions. More than half (66.7%) of the key medicines were available in stock. All the hospitals used the national medicine list but none of them had their own medicine list or guideline. In conclusion, majority of WHO stated core drug use indicators were not fulfilled by the eight hospitals. The results of this study suggest that a mix of policies needs to be implemented to make medicines more accessible and used in a more rational way.

ObjectiveTo assess the prevalence and practice of self-medication and its associated factors among ophthalmic patients.DesignAn analytical cross-sectional study design was employed.SettingThree hospitals inAsmara, Eritrea.ParticipantsSamples of ophthalmic outpatients aged >18 years who visited the three hospitals in Asmara, Eritrea. Systematic random sampling was used to select the study participants.Data collection and analysisData were collected from September 2021 to October 2021 in a face-to-face interview using a structured questionnaire. The collected data were double entered and analysed using CSPro (V.7.2) and SPSS (V.26), respectively. Descriptive statistics and logistic regression were performed. P values less than 0.05 were considered as significant.Primary and secondary outcome measuresMain outcome variable was practice of self-medication with ophthalmic drugs (SMOD). Secondary outcome measure was the determinants of self-medication practice.ResultsA total of 351 participants were recruited with a response rate of 97.7%. The prevalence of SMOD was found to be 14.9% (95% CI (11.1% to 18.7%)). The most frequently preferred ophthalmic drug groups were antibiotics (63.6%), followed by corticosteroids (22.7%). The main reasons for SMOD were easy accessibility (52.9%) and previous familiarity of the eye medication (27.5%). Eye redness (n=19/51) and foreign body sensation (n=18/51) were the most self-recognised complaints that required self-medication. The most common source of information for SMOD was pharmacy professionals (41.1%). Only attitude score (Crude odds ratio (COR)= 1.25, 95% CI 1.12, 1.39) was significantly associated with the practice of SMOD at bivariate logistic regression.ConclusionThough the majority of respondents considered self-medication with ophthalmic drugs as inappropriate, a significant number of them practising it. This mandates relevant bodies to take stricter measures to protect the public from the misuse of eye medications.

Background Globally, the usage of herbal medicines (HMs) is increasingly growing in treating and preventing various ailments. Although, HMs play a vital role in healthcare, concerns have been raised over their safety. Since pharmacy professionals are at the right position to provide patients with evidence-based information on herbals, they should be knowledgeable enough on the subject matter. Thus, the aim of the study was to assess the knowledge, attitude and prevalence of HMs use and its associated factors among pharmacy professionals. Method An analytical cross-sectional study was conducted among pharmacy professionals working in drug retail outlets in Asmara (the capital city of Eritrea). A census design was employed and data were collected through face-to-face interview. Data were entered and analyzed using Census and Survey Processing System (version-7.2) and IBM Statistical Package for Social Sciences (version 26), respectively. Descriptive and analytical statistics including Mann-Whitney U test/Kruskal-Wallis test and logistic regression were employed. P-values less than 0.05 were considered as significant. Results A total of 50 pharmacy professionals (90.9% response rate) were enrolled in the study. Majority of them (62%) were males and two-thirds had a bachelor’s degree. The overall median (Interquartile range, IQR) knowledge score was found to be 24 (12.16) out of 100 with a minimum score of 8 and maximum score of 53. Generally, the median (IQR) attitude score was 70.4 (4.2) out of 100. Majority (78%) of them had used HM for self-treatment. Only religion was found to be a significant determinant of knowledge on indication of HMs (p = 0.015), while attitude score was independent of the potential determining factors. Moreover, prevalence of use was significantly associated with pharmacy ownership (Adjusted Odds Ratio (AOR) =14.44, 95%Confidence Interval (CI): 1.67, 124.52) as well as with the percentage attitude score (AOR = 0.632, 95%CI: 0.41, 0.96) at multivariable level. Conclusion Generally, the overall knowledge score of pharmacy professionals was low. However, they possessed positive attitude towards herbal medicines. Besides, there was prevalent usage of herbal medicine for self-treatment. This outcome triggers the need for educational courses and workshops centered on herbal medicine.

Background Globally, preventable medication-related problems are increasing constantly. Patient-centered communication (PCC) is essential to identify and reduce the occurrence of drug-related problems such as inappropriate use of medications, adverse drug reactions and non-adherence. In Eritrea, personal observations and anecdotal reports showed that pharmacy professionals’ practice towards PCC was unsatisfactory. This study was conducted to assess pharmacy professionals' knowledge, attitude, self-efficacy and barriers towards the practice of PCC. Methods An analytical cross-sectional study design was employed among all pharmacy professionals who were employees of the drug retail outlets and hospital out-patient pharmacies of Asmara, Eritrea. A census approach was employed and data were collected from May to June 2021 using a face to face interview-based data collection tool. Descriptive and analytical statistics including independent samples t -test and multiple linear regression were employed using IBM SPSS (version-26). Results A total of 79 pharmacy professionals with a median age of 36 (IQR: 20) years were included in the study. The mean (SD) knowledge score of PCC was found to be 11.91 (2.0) out of 17. Moreover, the mean (SD) attitude score was 39.55 (4.0) out of 60 and the overall mean (SD) self-efficacy score was 52.51 (12.0) out of 96. Self-efficacy was significantly correlated with attitude ( p =0.015). Work setting (p=0.002) and training (p=0.045) were predictors for the sub-scales of self-efficacy ‘exploring patient’s perspectives’ and ‘dealing with communicative challenges’, respectively. Workload/shortage of pharmacy professionals and time constraint were found to be the main barriers of the pharmacy professionals for not practicing PCC. Conclusion Generally the pharmacy professionals’ fairly encouraging knowledge and attitude score on PCC, it was not supported with their self-efficacy. This necessitates further attention from policy makers and health facility managers in creating an ideal working environment for the pharmacy professionals to practice PCC at their best.

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