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Compliance of private pharmacies in Uganda with controlled prescription drugs regulations: a mixed-methods study

BACKGROUND: Controlled prescription drug use disorders are a growing global health challenge in Sub-Saharan Africa. Effective supply chain regulations on dispensing and stock control are important for controlling this epidemic. Since compliance with these regulations in resource-limited countries is...

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Autores principales: Kamba, Pakoyo Fadhiru, Mulangwa, John, Kaggwa, Bruhan, Kitutu, Freddy Eric, Sewankambo, Nelson Kaulukusi, Katabira, Elly Tebasoboke, Byakika-Kibwika, Pauline, Adome, Richard Odoi, Bollinger, Robert Cyril
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027211/
https://www.ncbi.nlm.nih.gov/pubmed/32070374
http://dx.doi.org/10.1186/s13011-020-00261-x
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author Kamba, Pakoyo Fadhiru
Mulangwa, John
Kaggwa, Bruhan
Kitutu, Freddy Eric
Sewankambo, Nelson Kaulukusi
Katabira, Elly Tebasoboke
Byakika-Kibwika, Pauline
Adome, Richard Odoi
Bollinger, Robert Cyril
author_facet Kamba, Pakoyo Fadhiru
Mulangwa, John
Kaggwa, Bruhan
Kitutu, Freddy Eric
Sewankambo, Nelson Kaulukusi
Katabira, Elly Tebasoboke
Byakika-Kibwika, Pauline
Adome, Richard Odoi
Bollinger, Robert Cyril
author_sort Kamba, Pakoyo Fadhiru
collection PubMed
description BACKGROUND: Controlled prescription drug use disorders are a growing global health challenge in Sub-Saharan Africa. Effective supply chain regulations on dispensing and stock control are important for controlling this epidemic. Since compliance with these regulations in resource-limited countries is poor, there is need to understand its predictors in order to reduce the risk of prescription drug use disorders. METHODS: A mixed-methods study utilizing a structured questionnaire and a simulated client guide was undertaken in Kampala and Mbale towns in Uganda. The questionnaire recorded self-reported dispensing and verified stock control practices and their covariates from 101 private pharmacies. The guide recorded actual dispensing practices from 27 pharmacies. Snowball sampling was done to enrich the sample with pharmacies that stock opioids. The mean compliance with good dispensing and stock control practices was calculated. Multivariate logistic regression analyses were applied to identify predictors of compliance. RESULTS: The mean compliance with dispensing and stock control requirements was 82.9% and 23%, respectively. Twenty percent and 40% of the pharmacies dispensed pethidine without a prescription and with invalid prescriptions, respectively. Having a pharmacist on duty (OR = 5.17; p = 0.02), prior in-service training on narcotics regulations (OR = 3.51; p = 0.04), and previous narcotics audits by the regulator (OR = 5.11; p = 0.01) were independent predictors of compliance with stock control requirements. Pharmacies with a previous history of poor compliance with dispensing requirements were less likely to demonstrate good compliance (OR = 0.21; p = 0.01). CONCLUSIONS: There is suboptimal compliance to controlled prescription drug regulations among Uganda’s pharmacies. A previous history of poor compliance to dispensing requirements predicted low compliance in subsequent assessments. Training and regulatory audits increased compliance in stock control but not dispensing. Expansion of training and audits to more pharmacies and/or incentives for compliance are necessary.
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spelling pubmed-70272112020-02-24 Compliance of private pharmacies in Uganda with controlled prescription drugs regulations: a mixed-methods study Kamba, Pakoyo Fadhiru Mulangwa, John Kaggwa, Bruhan Kitutu, Freddy Eric Sewankambo, Nelson Kaulukusi Katabira, Elly Tebasoboke Byakika-Kibwika, Pauline Adome, Richard Odoi Bollinger, Robert Cyril Subst Abuse Treat Prev Policy Research BACKGROUND: Controlled prescription drug use disorders are a growing global health challenge in Sub-Saharan Africa. Effective supply chain regulations on dispensing and stock control are important for controlling this epidemic. Since compliance with these regulations in resource-limited countries is poor, there is need to understand its predictors in order to reduce the risk of prescription drug use disorders. METHODS: A mixed-methods study utilizing a structured questionnaire and a simulated client guide was undertaken in Kampala and Mbale towns in Uganda. The questionnaire recorded self-reported dispensing and verified stock control practices and their covariates from 101 private pharmacies. The guide recorded actual dispensing practices from 27 pharmacies. Snowball sampling was done to enrich the sample with pharmacies that stock opioids. The mean compliance with good dispensing and stock control practices was calculated. Multivariate logistic regression analyses were applied to identify predictors of compliance. RESULTS: The mean compliance with dispensing and stock control requirements was 82.9% and 23%, respectively. Twenty percent and 40% of the pharmacies dispensed pethidine without a prescription and with invalid prescriptions, respectively. Having a pharmacist on duty (OR = 5.17; p = 0.02), prior in-service training on narcotics regulations (OR = 3.51; p = 0.04), and previous narcotics audits by the regulator (OR = 5.11; p = 0.01) were independent predictors of compliance with stock control requirements. Pharmacies with a previous history of poor compliance with dispensing requirements were less likely to demonstrate good compliance (OR = 0.21; p = 0.01). CONCLUSIONS: There is suboptimal compliance to controlled prescription drug regulations among Uganda’s pharmacies. A previous history of poor compliance to dispensing requirements predicted low compliance in subsequent assessments. Training and regulatory audits increased compliance in stock control but not dispensing. Expansion of training and audits to more pharmacies and/or incentives for compliance are necessary. BioMed Central 2020-02-18 /pmc/articles/PMC7027211/ /pubmed/32070374 http://dx.doi.org/10.1186/s13011-020-00261-x Text en © The Author(s) 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Kamba, Pakoyo Fadhiru
Mulangwa, John
Kaggwa, Bruhan
Kitutu, Freddy Eric
Sewankambo, Nelson Kaulukusi
Katabira, Elly Tebasoboke
Byakika-Kibwika, Pauline
Adome, Richard Odoi
Bollinger, Robert Cyril
Compliance of private pharmacies in Uganda with controlled prescription drugs regulations: a mixed-methods study
title Compliance of private pharmacies in Uganda with controlled prescription drugs regulations: a mixed-methods study
title_full Compliance of private pharmacies in Uganda with controlled prescription drugs regulations: a mixed-methods study
title_fullStr Compliance of private pharmacies in Uganda with controlled prescription drugs regulations: a mixed-methods study
title_full_unstemmed Compliance of private pharmacies in Uganda with controlled prescription drugs regulations: a mixed-methods study
title_short Compliance of private pharmacies in Uganda with controlled prescription drugs regulations: a mixed-methods study
title_sort compliance of private pharmacies in uganda with controlled prescription drugs regulations: a mixed-methods study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027211/
https://www.ncbi.nlm.nih.gov/pubmed/32070374
http://dx.doi.org/10.1186/s13011-020-00261-x
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