BackgroundDrug promotion by medical representatives is one of the factors that influence physicians’ prescribing decisions and choice of drugs.ObjectiveTo assess the influence of medical representatives on prescribing practice of physicians in health facilities, Mekelle, Northern Ethiopia.Materials and MethodsFacility-based cross-sectional study was conducted enrolling all physicians working in public and private health facilities. All public and private health facilities were included and similarly, all physicians rendering services in these facilities were sampled in the study. The data were collected from February to March, 2015. Data were then entered into Epidata Version 3.1 and transferred to STATA version 12 for analysis. Both bivariable and multivariable logistic regressions were used to determine predictors.ResultsOf the ninety physicians approached in this study, 40 (48.2%) of the physicians believed that their prescribing decisions were influenced by visits of medical representatives (MRs). The odds of physicians who received gifts from MRs being influenced to prescribe their respective products was six times higher than those who reported not accepting any gifts [AOR = 6.56, 95% CI: 2.25, 19.13]. Stationery materials 23(35.4%) and drug samples 20(54.2%) were the commonest kinds of gifts given to physicians and face to face talking 45(54.2%) was the most frequent promotional methods. The finding of this study showed that around thirty-nine percent of MRs have had negative attitude toward competitors’ product. Moreover, working in private health facility was also another predictor of influence of prescribing decision in the study area [AOR = 12.78, 95% CI: 1.31, 124.56].ConclusionNearly half of the physicians working in Mekelle reported that their prescribing decisions were influenced by MRs in the last 12 months. Accepting gifts and working in private health facilities were predictors of influencing prescribing decisions. However, most MRs fails to provide adequate and accurate information regarding their products and they had a negative attitude towards the competitors’ product(s).

Background: Potentially inappropriate medication (PIM) use includes the use of drugs with higher risk where adverse drug effect outweighs the clinical benefit, especially when more effective alternative therapy is available. Objective: The aim of this study was to assess prevalence and risk factors associated with the use of PIMs in elderly patients at medical ward of Ayder Referral Hospital (ARH), Tigray region, Northern Ethiopia. Methods: A facility based prospective cross sectional study was conducted among 140 elderly patients from February 6, 2014 to May 05, 2014 in ARH. Patients with age ≥ 60 years admitted to medical ward during the study period were randomly selected. Data were collected with a structured questionnaire and analyzed using statistical package for social science (SPSS, IBM Corporation) version 20. Binary logistic regression was used to analyze factors associated with occurrence of PIM. Results: Of 140 patients, 52.1% were males and forty (28.6%) of patients received at least one potentially inappropriate medication. The most commonly used potential inappropriate medications were metoclopramide (25.58%), nifedipine (16.28%), diazepam (13.95%) and meperedine (13.95%). Above half of (58%) patients encountered polypharmacy. Thirty eight percent of the participants' had comorbid conditions. In the binary logistic analysis, patients with polypharmacy were more likely to receive PIMs [AOR 4.163: 95 % CI 1.75-9.92, p=0.001]. Conclusions: Prevalence of PIMs in elderly patients admitted to ARH was high. Polypharmacy was identified as the independent predicator of the uses of PIMs. Clinical pharmacists' are in a position to alert and monitor the exposure to PIMs as part of multidisciplinary team.

IntroductionPatient counseling can ideally be providing medication information orally or in written form to patients or their attendants, and it helps to form a concordant approach on encouraging patient involvement in the pharmaceutical care process and to explore patient’s knowledge and understanding. Lack of adequate knowledge on drugs and up-to-date drug information are the major factor that hinders counseling services. This study assessed counseling practice of pharmacy professionals in Mekelle City.MethodsA facility-based cross-sectional study was conducted. Professionals who volunteered to participate were involved. Self-administered questionnaires were used as data collecting tool to grasp professionals’ practice on patient counseling, and the data were analyzed by using SPSS version 23. One-way analysis of variance and post hoc statistical tests were done to check for association between sociodemographic and other variables of counseling practice. In the statistical analyses, p-value of 0.05 and 95% confidence interval were considered.ResultsThe most frequent drug information given by the pharmacy professionals to clients were unit dose (65%), frequency of administration (79%), and duration of therapy (62%). Study participants claimed that lack of knowledge (37%), lack of updated drug information (49%), high patient load (62%), and absence of a private counseling room (51%) were the main factors that prohibit pharmacy professionals from counseling their patients. Those pharmacy professionals whose monthly income was <2000 Ethiopian Birr claimed lack of knowledge (p=0.007), limited access for updated drug information (p=0.009), and lack of experience (p=0.039) as factors for poor counseling practice. Results of the post hoc analysis showed significant difference among the participants with <5 and >10 years of experience in providing information on storage conditions and written materials with p-value of 0.025 and 0.016, respectively.ConclusionThis study proves that the level of satisfactory counseling is still very low compared to the expected practice. Lack of knowledge, lack of updated drug information, high patient load, absence of private counseling room, and underestimating the importance of counseling were identified as some of the factors that impede counseling services.

Introduction: Generic medicines are produced by multiple manufacturers hence, are usually cheaper than innovator brands and therefore save costs on medicines. Many physicians oppose brand substitution, believing generic medicines to be inferior to their originator counterparts. Physicians' belief about generic medicines and factors affecting generic prescribing in Ethiopia are poorly investigated. Objective: To assess the physicians' belief about generic medicines and to identify factors affecting generic medicines prescribing in private health facilities, Mekelle, Northern Ethiopia. Materials and Methods: An institution based cross-sectional study was conducted enrolling all physicians working in private health facilities. The data were collected from January 2016 to March 2016. Data were collected using self-administered structured questionnaires measuring generic medicines belief of physicians using a Likert scale of 1-5. Data were then entered into SPSS version 20 for analysis. Results: Of the fifty-six physicians approached in this study, 50 (89.2% response rate) questionnaires were included in the analysis. Nearly three-fourth (72%) of the physicians claimed that they always prescribe generic medicines. More than half (55.3) of the respondents beliefs generic medicines have different active ingredients than a brand innovator. Almost equal percentage (52% and 54%) of the Physicians disagreed with brand medicines were safer than generic medicines and prescribing generic due to the complicated health problem of the patient respectively. Around two third (67.5%) of physicians reported that quality profile of medicine was a major reason for prescribing generic medicines. Moreover, availability of medicines in pharmacies and low cost of medicines were the main reasons for prescribing generic medicines with 58.1% and 52.4% respectively. Conclusion: The majority of physicians do not have a positive perception of generic medicines and a significant portion of the physician's belief brand medicines safer and effective than generic counterparts. The availability of medicines in pharmacies, low cost of medicines and purchasing power of the patients are major factors affecting generic medicines prescribing.