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Rakib-BPJ-2015

This study surveys the role of community pharmacists in Dhaka city, Bangladesh, highlighting their importance in medication safety and healthcare. It reveals a lack of qualified pharmacists, with most being C-grade and providing limited clinical services, such as medication counseling and adverse drug reaction reporting. The authors recommend government initiatives to enhance the community pharmacy sector for better patient care.

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0% found this document useful (0 votes)
13 views6 pages

Rakib-BPJ-2015

This study surveys the role of community pharmacists in Dhaka city, Bangladesh, highlighting their importance in medication safety and healthcare. It reveals a lack of qualified pharmacists, with most being C-grade and providing limited clinical services, such as medication counseling and adverse drug reaction reporting. The authors recommend government initiatives to enhance the community pharmacy sector for better patient care.

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A Survey of the Role of Community Pharmacists in Dhaka city, Bangladesh

Article in Bangladesh Pharmaceutical Journal · July 2015


DOI: 10.3329/bpj.v18i2.24312

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Bangladesh Pharmaceutical Journal 18(2): 137-141, 2015

A Survey of the Role of Community Pharmacists in Dhaka city,


Bangladesh
Abdur Rakib, Md. Shahid Sarwar, Shaheda Zannah, Sayema Khanum and Mamunur Rashid
Department of Pharmacy, Southeast University, Banani, Dhaka-1213, Bangladesh

Received: May 10, 2015; Accepted: June 15, 2015; Published (Web): July 21, 2015

Abstract
Community pharmacists play a vital role in improving medication safety and better healthcare facility to the
community. Unfortunately, the field of community pharmacy in Bangladesh is still to be developed and there is
scarcity of data regarding current role of community pharmacists in Bangladesh. The present study was conducted
to find out the role of community pharmacists in Bangladesh. For the study purpose, we visited 42 retail pharmacies
in Banani, Khilkhet and Uttra areas of Dhaka city and interviewed the community pharmacists working there. We
found that there were total 50 community pharmacists in 42 retail pharmacy and also observed that most of the
pharmacists (64%) worked alone. Interestingly, we didn’t find a single A-grade pharmacist working as community
pharmacist. B-grade pharmacists who completed a 3 year diploma in pharmacy were only 4 in number and 92% of
them were C-grade pharmacists with 3-4 months training. The average age of the participants was 29.6 ± 1.2 years.
The average length of service for the community pharmacists was 7.6 ± 1.3 years. The top issues that patients
consulted with the pharmacists were on medication use (76%), which physician they should visit (54%) and therapy
(26%). There was not a significant effect of work experience of community pharmacists on their attitudes toward
community-based clinical services. In this study, we observed that 95% community pharmacies provide blood
pressure measurement facility, 90% provide diabetes screening, 76% provide dressing services, and only 47%
provide nebulization. No community pharmacist was found to be involved with adverse drug reaction reporting. In
conclusion, we recommend that the government and the pharmacy regulatory authority should take sufficient
initiatives to develop the community pharmacy sector in Bangladesh for the welfare of mankind.

Key words: Community pharmacists, retail pharmacy, patient care, Bangladesh

Introduction final link between the medication and the patient.


Everyday millions of people across the world seek Community pharmacies have always been a major
their health care needs to the community pharmacists. location for health care worldwide. Pharmacy employees
Patients rely on community pharmacists for counselling are consulted for health advice on problems of all kinds,
because they are the most available and trusted healthcare and remedies are sold or dispensed with almost every
providers (Yegenoglu et al., 2005). Currently, pharmacists transaction. Some of the remedies are safe and effective
are shifting their role from a drug-focused approach when used correctly but otherwise can be dangerous;
towards a patient centred approach with the aim of others are ineffective no matter how they are used
achieving better outcomes from drug therapy (Poudel (Matheson et al., 2002; Adepu and Nagavi, 2006).
et al., 2009). In addition, due to the continuous progress in Bangladesh, the seventh most populous country (with
pharmacy profession, the scope of this profession is about 161 million people) in the world and it is estimated
changing from drug manufacturing and quality that the population of the country will become nearly
management to providing drug information and patient double by 2050 (Streatfield and Karar, 2008). With such a
care (Yegenoglu et al., 2005). But yet not all roles of huge population density (1142.29/Km2), there are only
community pharmacy services beyond medication advice fewer numbers of pharmacists who have been serving in
or supply have been utilised to their full potential. hospitals and community pharmacies. The insufficiency of
Pharmacists and other dispensers are in many cases the number of qualified pharmacists forces the patient toward

Correspondence to: Mamunur Rashid; E-mail: [email protected]


138 Rakib et al. / Bangladesh Pharmaceutical Journal 18(2): 137-141, 2015

inappropriate use of medication either from the error in the Table 1. Total number of study subjects.
prescription by the physician or from the self-medication. Study subjects Number
Irrational drug therapies may causes unproductive and Total number of pharmacy studied 42
perilous treatment, exacerbation or prolongation of illness, Total number of working pharmacists 50
distress and harm to patient, increased burden of A grade pharmacists 0
treatment. The most common causes of irrational use of B grade pharmacists 4
drugs are lack of information, imperfect and insufficient C grade pharmacists 46
training and education of medical graduates, poor
communication between health professionals and patients, Demographic characteristics of the community
lack of diagnostic facilities or uncertainty of diagnosis, pharmacists: The average age of the participants was
demand from patient, defective drug supply or ineffective 29.6 ± 1.2 years. The average length of service for the
drug regulation, and promotional activities of community pharmacists was 7.6 ± 1.3 years (Figure 1).
pharmaceutical industries (Shivhare et al., 2010). Among 42 retail pharmacists, only 16% pharmacists
Considering all these factors, the present study was completed their graduation, whereas 62% and 22%
designed to identify the current status of community completed HSC and SSC respectively (Figure 2).
pharmacy services and role of community pharmacists in Demographic characteristics of respondents are presented
different selected areas of Dhaka city, Bangladesh. in table 2.

Methods Table 2. Demographic characteristics of the community


pharmacists.
In our study, we tried to evaluate the role of
community pharmacists in the several retail pharmacies in Characteristics Respondents (n)
Banani, Khilkhet and Uttara areas of Dhaka city. For this Sex (n = 50) Female 0
Male 50
purpose, each retail pharmacist was interviewed with a Experience (years) 0-5 28
structured questionnaire. The questionnaire was designed 6-10 12
with the educational background, age, sex, experience and 11-15 8
15+ 2
grade of the community pharmacists, their knowledge Education SSC 11
about the drugs, drugs storage and various services and HSC 31
advices they provide to the patients and customers. The Hons 8
community pharmacists who denied to participate and
who disagreed to share the necessary information were Issues that the patients discussed with community
excluded from the study. pharmacists: Participating pharmacists were given an
open-ended question to offer topics on which their patients
Results in the community setting consult them. “Name of the drug,
Study subjects: Total 42 retail pharmacies from three directions for usage, side effects and duration of use” were
different regions of Dhaka city including Banani, Khilkhet classified as “medication use”, “information about their
and Uttara were included in this study. In most retail current treatment” as “therapy”, and “which physician to
pharmacy (64%) shops, pharmacists worked alone. 50 see for their ailments” as “physician”. The top issues that
pharmacists working in these retail pharmacies were patients consulted the pharmacists were on medication
included in this study. As the sector of community uses (76%), which physician they should visit (54%) and
pharmacy is not well developed in Bangladesh, we didn’t therapy (26%) (Table 3).
find a single A-grade pharmacist (Table 1). B-grade Awareness of community pharmacists about their job
pharmacists who completed a 3 years diploma in responsibilities: There was not a significant effect of work
pharmacy were only 4 in number, whereas the remaining experience of community pharmacists on their attitudes
of them were C-grade pharmacists (92%). toward community-based clinical services. Table 4 shows
Rakib et al. / Bangladesh Pharmaceutical Journal 18(2): 137-141, 2015 139

the awareness of community pharmacists toward their role


in community based clinical services.
Key services of retail pharmacy: In this study, we
observed that community pharmacists in the study area are
not effective in managing and following the drug therapy
for patients. Only 4% community pharmacists informed
the patient about the duration of drug use, drug name and
different features and side effects of drugs. Only 2%
pharmacists informed about storage condition. Table 5
shows the facilities of retail pharmacy provided for the
patients in Banani, Khilkhet and Uttra area.
Figure 2. Experiences of community pharmacists.
Table 3. Issues that patients discussed with community
pharmacists.

Issues discussed N (%)


Medication used 38 (76)
Therapy 13 (26)
Physician 27 (54)
Health in general 8 (16)
Diagnosis 2 (4)

Figure 3. Educational qualification of the community


pharmacists.

Figure 1. Different grades of pharmacist among the respondents.

Table 4. Awareness of community pharmacists about their job responsibilities.

Responsibilities Responses (%)


Yes No
Consulting and informing doctors and other health personnel 8 92
Taking drug history of the patient 12 88
Explaining the test results to the patient 14 86
Consultancy on OTC drugs (self therapy) 22 78
Counseling about drug interactions 2 98
Give antibiotics without prescription 82 18
Give sedative and narcotic drugs without prescription 80 20
Being informed about health risks 12 88
Counseling about social education themes 2 98
Reporting adverse drug reaction 0 100
140 Rakib et al. / Bangladesh Pharmaceutical Journal 18(2): 137-141, 2015

Table 5. Key services provided by the community pharmacists.

Subject analyzed Responses (%)


Yes No
Informing patients or relatives about the duration of drug use 4 96
Informing patients or relatives about drug administration route 6 94
Informing patients or relatives about drug dose and schedule 2 98
Informing patients or relatives about drug storage conditions 2 98
Informing patients or relatives about drug name and features 4 96
Warning patients or relatives about side effects of drugs 4 96
Informing patients on detrimental health effects of smoking 8 92

Clinical screening by retail pharmacists: In this study area. However, we found that some people who
study, we observed that 95% retailer measure blood completed their graduation involved themselves as
pressure, 90% provide diabetes screening, 76% provide community pharmacists. Although this was very small in
dressing services and only 47% provide nebulization number but this provide us new hope that A-grade
(Table 6). pharmacists who completed their graduation in pharmacy
might involve with this profession in near future. One of
Table 6. Clinical screening provided by the community the main responsibilities of community pharmacists is to
pharmacists. consult with physician and nurses for providing better
healthcare facility to the patients (Albanese et al., 2010).
Screenings Responses (n) Percentages
Unfortunately, in our study we observed that limited
Yes No
number of pharmacists maintained communication with
Blood pressure 40 2 95%
physician and other health professionals. Reporting
Diabetes 38 4 90%
medication histories are very essential to prevent
Dressings 32 10 76%
prescription errors and subsequent risks to the patients.
Nebulization 20 22 47%
Accurate medication histories are also important in
detecting drug-related pathology or changes in clinical
Discussion signs that may be the result of drug therapy. A good
Poor adherence to medication is a major problem medication history should encompass all currently and
among patients with chronic diseases (Martin et al., 2005). recently prescribed drugs, previous adverse drug reactions
The pharmacist could be a coordinator between different including hypersensitivity reactions, any over-the counter
members of healthcare team and the patients. Thus, medications, including herbal or alternative medicines,
involvement of pharmacists in health management system and adherence to therapy (Gerald, 2009). This study found
is becoming very crucial day by day. Community that community pharmacists were not interested either to
pharmacists come in direct contact with the public and document the previous drug history of the patients or to
they not only dispense medications but also counsels explain the results of their test reports.
patients regarding general health topics such as diet, Patients counselling about different drug-drug and
exercise, stress management, over-the-counter drug-food interaction have paramount importance to avoid
medications etc. Some community pharmacists also the possible undesirable effects (Hussain, 2011). But we
provide specialized services to help patients with diabetes, found that only negligible numbers of pharmacists offer
asthma, smoking cessation, drug addiction, and patients this service to the patients which are one of the major
with high blood pressure (Shill and Das, 2011; Lipton et causes of the unwanted side effects and inferior drug
al., 1995). action to the patients. We also observed that the
In our study, we found that there are not sufficient community pharmacists have tendency to dispense
number qualified community pharmacists working in our antibiotic and sedative-hypnotic drugs without
Rakib et al. / Bangladesh Pharmaceutical Journal 18(2): 137-141, 2015 141

prescription. This type of tendency may lead to some Albanese, N.P., Rouse, M.J. and Council on Credentialing in
potentially detrimental effect including antibiotic Pharmacy. 2010. Scope of contemporary pharmacy
practice: roles, responsibilities, and functions of
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of administration, drug storage conditions, possible side accurate drug history. Br. J. Clin. Pharmacol. 67, 671-675.
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