Règlementation pharmaceutique au Tchad: état de lieux des pratiques de délivrance des médicaments dans les officines privées de N’Djaména

INTRODUCTION: the purpose of this study was to evaluate drug dispensing practices in private pharmacies in the city of N'Djamena and, specifically, (I) to describe the characteristics of dispensaries, (ii) describe dispensing practices and (iii) assess regulatory compliance when dispensing on the basis of a prescription and an advice. METHODS: we conducted a cross-sectional survey from June to December 2020. Data were collected in two stages, through interviews with pharmacists and participant observation in drug delivery practices in pharmacies. RESULTS: in total, 26 pharmacies, or 50% of pharmacies in N'Djamena, were surveyed. The main survey findings were: private pharmacies in the city of N'Djamena employed two categories of staff, namely pharmacists and auxiliary staff (pharmacy technicians, nurses and salespeople or staff with “no health qualifications”. These had not been trained in a health school recognised by the Ministry of Health) to dispense medicines. Very few pharmacies (8%) had a customer confidentiality area and a order book. The three modes of delivery were observed in more or less equal proportions (30 to 40% of dispensations). Dispensing at the patient's request was slightly predominant (40%) and the majority of medicines dispensed at the patient's request and based on dispenser's advice belonged to the different tables of toxic substances (over 70%). The noted absence of the pharmacist from the pharmacy justified why 84% of patients' requests were addressed to the pharmacy assistants. CONCLUSION: this study shows low compliance of pharmacies with pharmaceutical regulations for proper dispensing of medicines in the city of N'Djamena. Factors related to pharmaceutical sector governance and human resources management as well as therapeutic patient education could explain this gap.