Prospective encounter study of the degree of adherence to patient care indicators related to drug dispensing in Health Care facilities: A Sri Lankan perspective

Abstract

The World Health Organization-recommended patient care indicators in Government Hospitals were assessed in 422 patients attending the Outpatient Department in selected hospitals of the Galle district in Southern Province. The average dispensing time (ADT), percentage of drugs actually dispensed (PDAD), percentage of drugs adequately labeled (PDAL) and patient's knowledge on correct dosage (PKCD) were compared in these selected teaching hospitals (TH), general hospitals (GHs) and district hospitals (DHs) in Galle. ADT in DH (1.16 min) and GH (1.07 min) were high when compared with ADT in TH (0.81 min). PDAD was 100% in DH, 97.79% in GH and lowest in TH (94.64%). PDAL was highest (22.66%) in TH, 17.57% in GH and lowest in DH (1.57%). PKCD was 100% in GH and lowest in DH (0%) and only 50% in TH in Galle district. We noted that there was a significant difference in ADT in all three categories (P < 0.05). We noted that dispensers spend only a short dispensing time and showed a tendency for dispensing errors. We found that PDAL was very low in all hospitals but PDAD was significantly high. Even though the ADT was high in DH, PKCD was 0% due to negligence in dispensing practices. We also noted a 100% PKCD only in GH due to the practice of a well-prepared correct labeling system in GH. We noticed that these patients were provided drugs with inadequate labeling and that patients had only a poor knowledge about the drug administration schedule. We conclude that there was a low dispenser–patient ratio in all three hospitals and that there was a need for an implementation plan for proper dispensing techniques by introducing a well-prepared drug labeling system in a printed format.

Ward-based clinical pharmacists and hospital readmission: a non-randomized controlled trial in Sri Lanka

“…In this study, the proportion of the drug-related problems that were resolved was significantly higher in the intervention group than the control group, which also has been shown in other studies 5 , 23 , 24 . While one can assume that resolution of drug-related problems during the inpatient stay may have improved individual patient outcomes, our study was not powered to demonstrate this outcome.…”

“…Lack of provision of patient information on safe medication administration at discharge is a common problem within the Sri Lankan hospital system 23 . This intervention directly addressed this gap as an intervention pharmacist provided both verbal and written medication information to patients.…”

Opportunities for pharmacists to optimise quality use of medicines in a Sri Lankan hospital: an observational, prospective, cohort study

“…Pharmacists do not currently work at a ward level in collaboration with medical teams in government hospitals in Sri Lanka. They predominantly undertake a supply and dispensing function with minimal interaction with doctors and little provision of information to patients and carers . In 2006, the Sri Lankan government introduced new Bachelor of Pharmacy degree courses in order to develop a workforce capable of providing additional clinical services.…”

“…Patients' poor understanding of medicines taken prior to hospital admission could be explained by poor labelling (often lacking name, strength and dose instructions) as previously described in a Sri Lankan public hospital which showed that inadequate drug labelling, inadequate explanation of dosage regimen, precautions and clinically important side effects correlated with poor patient knowledge of correct medicine doses …”

“…In Sri Lanka, access to medicines has been largely addressed by free public health services and affordable medicines sourced within the region. Previous studies identified a requirement for better resources to support patient understanding and health professionals' prescribing and dispensing . In 2005, Sri Lanka's National Medicinal Drug Policy highlighted that improving QUM and development of the pharmacy profession as a member of the healthcare team should be prioritised…”