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Open Access Research article

Pharmacy practice and injection use in community pharmacies in Pokhara city, Western Nepal

Sudesh Gyawali1*, Devendra Singh Rathore2, Kishor Adhikari3, Pathiyil Ravi Shankar45, Vikash Kumar KC6 and Suyog Basnet3

Author Affiliations

1 Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Nepal

2 Department of Pharmacy, Rajasthan Pharmacy College, Jaipur, India

3 Department of Pharmaceutical Sciences, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal

4 Department of Pharmacology, KIST Medical College, Lalitpur, Nepal

5 Presently at Xavier University School of Medicine, Oranjestad, Aruba Kingdom of the Netherlands

6 Department of Statistics, PN Multiple Campus, Pokhara, Nepal

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BMC Health Services Research 2014, 14:190  doi:10.1186/1472-6963-14-190

Published: 28 April 2014

Abstract

Background

Community pharmacies in Nepal serve as the first point of contact for the public with the health care system and provide many services, including administering injections. However, there is a general lack of documented information on pharmacy practice and injection use in these pharmacies. This study aims to provide information about pharmacy practice in terms of service and drug information sources, and injection use, including the disposal of used injection equipment.

Methods

A mixed method, cross-sectional study was conducted in 54 community pharmacies in Pokhara city. Data was collected using a pre-tested, semi-structured questionnaire, and also by the direct observation of pharmacy premises. Interviews with pharmacy supervisors (proprietors) were also conducted to obtain additional information about certain points.

Results

Interviews were carried out with 54 pharmacy supervisors/proprietors (47 males and 7 females) with a mean age and experience of 35.54 and 11.73 years, respectively. Approximately a half of the studied premises were operated by legally recognized pharmaceutical personnel, while the remainder was run by people who did not have the legal authority to operate pharmacies independently. About a quarter of pharmacies were providing services such as the administration of injections, wound dressing, and laboratory and consultation services in addition to medicine dispensing and counseling services. The ‘Current Index of Medical Specialties’ was the most commonly used source for drug information. Almost two-thirds of patients visiting the pharmacies were dispensed medicines without a prescription. Tetanus Toxoid, Depot-Medroxy Progesterone Acetate, and Diclofenac were the most commonly-used/administered injections. Most of the generated waste (including sharps) was disposed of in a municipal dump without adhering to the proper procedures for the disposal of hazardous waste.

Conclusions

Community pharmacies in Pokhara offer a wide range of services including, but not limited to, drug dispensing, counseling, dressing of wounds, and administering injections. However, the lack of qualified staff and adequate infrastructure may be compromising the quality of the services offered. Therefore, the health authorities should take the necessary measures to upgrade the qualifications of the personnel and to improve the infrastructure for the sake of good pharmacy practice and the safer use of injections.

Keywords:
Community pharmacies; Developing countries; Health care waste; Injection disposal; Nepal; Safe injection practice; Sharps