Cargando…

Medical abortion drug dispensing practices among private pharmacy workers in Nepal: A mystery client study

BACKGROUND: Pharmacies are the first point of contact for women seeking medical abortion (MA) and act as important sources of information and referral in Nepal. Over the counter sale of MA drugs is not currently allowed in Nepal. This study aimed to assess the MA drug dispensing practices of pharmac...

Descripción completa

Detalles Bibliográficos
Autores principales: Sigdel, Anil, Angdembe, Mirak Raj, Khanal, Pratik, Adhikari, Nilaramba, Maharjan, Alina, Paudel, Mahesh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9683563/
https://www.ncbi.nlm.nih.gov/pubmed/36417473
http://dx.doi.org/10.1371/journal.pone.0278132
_version_ 1784835077137498112
author Sigdel, Anil
Angdembe, Mirak Raj
Khanal, Pratik
Adhikari, Nilaramba
Maharjan, Alina
Paudel, Mahesh
author_facet Sigdel, Anil
Angdembe, Mirak Raj
Khanal, Pratik
Adhikari, Nilaramba
Maharjan, Alina
Paudel, Mahesh
author_sort Sigdel, Anil
collection PubMed
description BACKGROUND: Pharmacies are the first point of contact for women seeking medical abortion (MA) and act as important sources of information and referral in Nepal. Over the counter sale of MA drugs is not currently allowed in Nepal. This study aimed to assess the MA drug dispensing practices of pharmacy workers using mystery clients in Nepal. METHODS: A cross-sectional study using the mystery client approach was conducted in 266 pharmacies in September-October 2019. These pharmacies had either received harm reduction training or medical detailing visits. A total of 532 visits were conducted by six male and six female mystery clients. Mystery clients without prescription approached the sample pharmacy and filled out a standard digital survey questionnaire using the SurveyCTO application immediately after each interaction. RESULTS: Pharmacy workers dispensed MA drugs in 35.7% of the visits while they refused to provide MA drugs to the mystery clients in 39.3% of visits. Lack of evidence of prior consultation with a physician (27.5%), referral to other health facilities (21.8%), unavailability of MA drugs in the pharmacy (21.3%) and lack of prescription (16.4%) were the main reasons for refusal. Seventy percent of the pharmacy workers inquired clients about last menstrual period/months of pregnancy while 38.1% asked whether the pregnancy status was confirmed. During 65.1% of the visits, mystery clients were told about when to take the MA drugs while in 66.4% of visits, they were told about the route of drug administration. Similarly, mystery clients were briefed about what to expect during the abortion process in half of the visits, and information about the possible side effects of the MA drug was provided in 55.9% of the visits. Pharmacy workers provided correct information on taking MA drugs to mystery clients in 70.7% of visits. CONCLUSION: Despite legal provision of sale of MA drugs only on prescription, pharmacy workers dispensed MA drug in one out of three visits. As pharmacies are the initial contacts of women for abortion services in Nepal, correct supplementary information through pharmacy workers can be an effective strategy to expand access to quality safe abortion services.
format Online
Article
Text
id pubmed-9683563
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-96835632022-11-24 Medical abortion drug dispensing practices among private pharmacy workers in Nepal: A mystery client study Sigdel, Anil Angdembe, Mirak Raj Khanal, Pratik Adhikari, Nilaramba Maharjan, Alina Paudel, Mahesh PLoS One Research Article BACKGROUND: Pharmacies are the first point of contact for women seeking medical abortion (MA) and act as important sources of information and referral in Nepal. Over the counter sale of MA drugs is not currently allowed in Nepal. This study aimed to assess the MA drug dispensing practices of pharmacy workers using mystery clients in Nepal. METHODS: A cross-sectional study using the mystery client approach was conducted in 266 pharmacies in September-October 2019. These pharmacies had either received harm reduction training or medical detailing visits. A total of 532 visits were conducted by six male and six female mystery clients. Mystery clients without prescription approached the sample pharmacy and filled out a standard digital survey questionnaire using the SurveyCTO application immediately after each interaction. RESULTS: Pharmacy workers dispensed MA drugs in 35.7% of the visits while they refused to provide MA drugs to the mystery clients in 39.3% of visits. Lack of evidence of prior consultation with a physician (27.5%), referral to other health facilities (21.8%), unavailability of MA drugs in the pharmacy (21.3%) and lack of prescription (16.4%) were the main reasons for refusal. Seventy percent of the pharmacy workers inquired clients about last menstrual period/months of pregnancy while 38.1% asked whether the pregnancy status was confirmed. During 65.1% of the visits, mystery clients were told about when to take the MA drugs while in 66.4% of visits, they were told about the route of drug administration. Similarly, mystery clients were briefed about what to expect during the abortion process in half of the visits, and information about the possible side effects of the MA drug was provided in 55.9% of the visits. Pharmacy workers provided correct information on taking MA drugs to mystery clients in 70.7% of visits. CONCLUSION: Despite legal provision of sale of MA drugs only on prescription, pharmacy workers dispensed MA drug in one out of three visits. As pharmacies are the initial contacts of women for abortion services in Nepal, correct supplementary information through pharmacy workers can be an effective strategy to expand access to quality safe abortion services. Public Library of Science 2022-11-23 /pmc/articles/PMC9683563/ /pubmed/36417473 http://dx.doi.org/10.1371/journal.pone.0278132 Text en © 2022 Sigdel et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Sigdel, Anil
Angdembe, Mirak Raj
Khanal, Pratik
Adhikari, Nilaramba
Maharjan, Alina
Paudel, Mahesh
Medical abortion drug dispensing practices among private pharmacy workers in Nepal: A mystery client study
title Medical abortion drug dispensing practices among private pharmacy workers in Nepal: A mystery client study
title_full Medical abortion drug dispensing practices among private pharmacy workers in Nepal: A mystery client study
title_fullStr Medical abortion drug dispensing practices among private pharmacy workers in Nepal: A mystery client study
title_full_unstemmed Medical abortion drug dispensing practices among private pharmacy workers in Nepal: A mystery client study
title_short Medical abortion drug dispensing practices among private pharmacy workers in Nepal: A mystery client study
title_sort medical abortion drug dispensing practices among private pharmacy workers in nepal: a mystery client study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9683563/
https://www.ncbi.nlm.nih.gov/pubmed/36417473
http://dx.doi.org/10.1371/journal.pone.0278132
work_keys_str_mv AT sigdelanil medicalabortiondrugdispensingpracticesamongprivatepharmacyworkersinnepalamysteryclientstudy
AT angdembemirakraj medicalabortiondrugdispensingpracticesamongprivatepharmacyworkersinnepalamysteryclientstudy
AT khanalpratik medicalabortiondrugdispensingpracticesamongprivatepharmacyworkersinnepalamysteryclientstudy
AT adhikarinilaramba medicalabortiondrugdispensingpracticesamongprivatepharmacyworkersinnepalamysteryclientstudy
AT maharjanalina medicalabortiondrugdispensingpracticesamongprivatepharmacyworkersinnepalamysteryclientstudy
AT paudelmahesh medicalabortiondrugdispensingpracticesamongprivatepharmacyworkersinnepalamysteryclientstudy