Importance of labelling and patient knowledge to ensure proper care during drug dispensing: A case study from a tertiary hospital in Ethiopia

Seblework Mekonen, Wondimu Samuel, Argaw Ambelu

Department of Environmental Health Sciences & Technology, Jimma University, Jimma, Ethiopia.
Graduate Program in Economic Development, Vanderbilt Uni-versity, Nashville, USA.

DOI: 10.4236/ojpm.2014.41001                

Abstract

Correct drug labelling is central for ensuring proper drug dispensing and thus for patient safety. Labelling errors may result in adverse health outcomes. The objective of this study was, therefore, to assess the effect of labelling on the quality of drug dispensing and patient knowledge about dispensed drugs in Jimma University model and specialized hospital outpatient Pharmacies. Individual packages with prescribed drugs were examined using pretested questionnaire and observational check lists during the dispensing process. Patients’ knowledge about drugs dispensed to them was assessed at the exit interview using a pretested questionnaire. Out of 743 prescribed drugs, 682 (91.8%) were dispensed to 426 patients. The average labelling score (range from 0 to 6) of dispensed drugs in Model and Outpatient pharmacy was 2.00 (95% CI 1.97 to 2.04) and 1.73 (95% CI 1.6 to 1.8) respectively, with overall average labelling score of 1.90 (95% CI 1.84 to 1.91). The average patient knowledge score (range from 0 t0 5) was 3.45 (95% CI 3.31 to 3.59) and 3.5 (95% CI 3.35 to 3.64) for model and outpatient pharmacy, respectively, while the overall average knowledge score was 3.46 (95% CI 3.37 to 3.57). Major labelling problems were absence of patient’s name and dose followed by frequency of administration, duration of treatment, and the reason for prescription. Literacy status of patients had a significant effect on their knowledge (p < 0.005) but age had not (p > 0.05). We recommend that corrective measures targeting both, labelling and patients’ knowledge should be implemented to improve the patients’ safety and drug therapy adherence.

Keywords

Labelling; Patient Knowledge; Patient Care; Outpatient Pharmacy; Dispensed Drug

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	World Health Organization (WHO). (1987) The rational use of drugs. Conference of Experts on the Rational Use of Drugs, Nairobi, 25-29 November 1985.
[2]	Laing, R.O. (1990) Rational drug use: An unsolved problem. Tropical Doctor, 20, 101-103.
[3]	Dukes, M.N.G. (1993) Drug utilization studies. Methods and uses. WHO Regional Publications, European Series No. 45. Copenhagen.
[4]	World Health Organization. (1997) Managing drug supply. 2nd Edition, Kumarian Press, West Hartford.
[5]	Smith, F. (2003) Drug use in Sub-Saharan Africa: Quality in processes—Safety in use. Quality and Safety in Health Care, 12, 164-165. http://dx.doi.org/10.1136/qhc.12.3.164
[6]	Boonstra, E., Lindbaek, M., Ngome, E., et al. (2003) Labeling and patient knowledge of dispensed drugs as quality indicators in primary care in Botswana. Quality and safe in Health Care, 12, 168-175.
[7]	Hogerzeil, H.V., Ross-Degnan, B.D., Laing, R.O., et al. (1993) Field-tests for rational drug use in twelve developing countries. Lancet, 342, 1408-1410. http://dx.doi.org/10.1016/0140-6736(93)92760-Q
[8]	Margaret-Mary, A. and David, O.A. (1997) The impact of three forms of educational interventions on dispensing practices. International Conferences on Improving Use of Medicines (ICIUM). http://mednet3.who.int/icium/icium1997/posters/2b1_txt1.html
[9]	Agency for Health Care Research and Quality (AHCQ). (2003) One third of elderly home health care patients are having problems with their medication. http://www.ahrq.gov/research/sepol
[10]	US Pharmacopial. (2003) USP releases fourth annual report on medication errors in US hospitals. US Pharmacopial, Rockville.
[11]	Liu, G.G. and Christensen, D.B. (2002) The continuing challenge of inappropriate prescribing in the elderly: An update of the evidence. Journal of American Pharmacists Association, 42, 847-857. http://dx.doi.org/10.1331/108658002762063682
[12]	World Health Organization (WHO). (1993) How to investigate drug use in heath facilities. Selected drug use indicators. World Health Organization, Geneva.
[13]	Oferi-Adjei, D. (1992) Report on Tanzanian field test. INRUD News, 3.
[14]	Massele, A.Y., Nsimba, S.E. and Rimoy, G. (2001) Prescribing habits in church-owned primary health care facilities in Dar es Salaam and other Tanzanian coast regions. East African Medical Journal, 78, 510-514. http://dx.doi.org/10.4314/eamj.v78i10.8958
[15]	Schillinger, D., Machtinger, E., Wang, F., Rodriguez, M., Bindman, A. (2005) Preventing medication errors in am-bulatory care: The importance of establishing regimen concordance. In: Henriksen, K., Battles, J.B., Marks, E.S. and Lewin, D.I., Eds., Advances in Patient Safety Research Implement Vol. 1 Research Findings, Agency for Healthcare Research and Quality, Rockville.
[16]	Jankovic, S.M., Maksimovic, M.R., Vusanovic, A., Kostic, I.R., Kovacevic, Z.N. and Mitric, M. (2001) Service quality in public and private pharmacies in the city of Kragujevac, Yugoslavia. Croatian Medical Journal, 42, 88-91.
[17]	Otoom, S., Batieha, A., Hadidi, H., Hasan, M. and Al-Saudi, K. (2002) Evaluation of drug use in Jordan using WHO patient care and health facility indicators. Eastern Mediterranean Health Hournal, 8, 544-549.
[18]	Dawit, D., Zeleke, G. and Shiferaw, T.M. (1998) A preliminary survey on drug dispensing pattern in some hospitals in Southern Nations, Nationalities and Peoples Region, Ethiopia. Communications, Ethiopian Pharmaceutical Journal, 16, 59-63.
[19]	Desta, Z., Abula, T., Beyene, L., Fantahun, M., Yohannes, A.G. and Ayalew, S. (1997) Evaluation of rational drug use and prescribing in primary health care facilities in Northwestern Ethiopia. East African Medical Journal, 74, 758-763.
[20]	Truter, I. (2006) Dispensing service research-pilot project. Pharmacia-Official Publication of the South African Pharmacy Council, 14, 2.