[e-drug] Patients behaviour when purchasing/obtaining drugs

e-drug
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E-DRUG: Patients behaviour when purchasing/obtaining drugs
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I just wanted to share with you some of the patients' behaviour that I have experienced while working in community and hospital pharmacy in my country.

Patients prefer to use drugs that they have previously used or that they have used for quite a long time, especially if the drugs worked well with them and hence when the products are no longer available in the market for any reason (like what happened with Nimesulide) they become so disappointed and may disagree with whatever advice/option you are giving until they are sure that they cannot get them anymore.

The negative part of this behaviour is that unlawfully businessmen continue to import the drugs patients want, illegally, making the job of regulatory authorities a bit complicated.

Patients always struggle to get the same name (brand) as it has been written by the prescriber.They do not change their mindset easily in the sense of accepting a substitute or a very similar product in terms of active ingredient from a different company.The negative part of this is that patients delay treatment until they get the same product or until they are sure that they can no longer receive the product because it is not iin the market.

Patients prefer using branded drugs from Europe (such as Nexium, Viagra, Zantac, Duracef, Augmentin, etc...) than generic versions from India, Malaysia, etc...unless the costs are too high for them or they are not available at all. The negative part of this is that sometimes we subject them to unnecessary expenses when we have the brand in stock and they have money in their pockets.

Can anyone inform me if the same behaviours exist at your settings?

Some may argue that these issues can be encountered through patients education programs either at the clinic, pharmacy or elsewhere. However, healthcare providers have limited time to educate the patients due to the queue at the clinics, patients condition that sometimes need urgent attention, low motivation in terms of salaries, etc...

Can any one give suggestions on any other best ways of educating patients that has been useful, excluding TV and Radio spots because of the obstacles such as high costs, absence of them in some rural areas and lack of details on the adverts due to limited time of airing the spots or programme?

Frank Komakoma
Pharmacist
Dar es Salaam
Tanzania
Frank Komakoma <fkoma@yahoo.com>

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E-DRUG: Patients behaviour when purchasing/obtaining drugs (2)
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Dear Frank,

I work as a Staff Pharmacist at a tertiary care hospital having both
hospital as well as community pharmacy practice. We run the formulary on a
generic basis and keep one brand of any given drug at a time. The physicians
have to prescribe the drug available since the patients have complete trust
on what they get from the hospital rather than any thing from outside the
hospital.

However, we have noticed that the trust really lies upon the doctor who
prescribes the medicine. It is difficult to educate the patients , but it is
easier to educate the doctors about the intricacies of cost/brand 'generic
drugs and the pharma companies. Yes, we depend on pharma companies for the
medicines, but then they depend on us , the health care providers as well,
no disease, no patients means NO medicines!!

So we need to train the physicians, give them proper and updated guidelines
and make sure they conform to those guidelines which are normally the
institution's, to ensure evidence based and cost effective practices.

Ms Ozma Fazal Khan. Staff Pharmacist
Coordinator Research, Training and Education
Dept of Pharmacy
The Aga Khan Hospital
Karachi, Pakistan
"ozma fazal" <ozma.fazal@gmail.com>

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E-DRUG: Patients behaviour when purchasing/obtaining drugs
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Dear Frank,

I have been following up this discussion for a couple of days. Frank
komakoma and Fasal has touched what is happening in health facilities.
I did a thesis on improving professional practice in management of
hiv/AIDS . One area was how how we can improve good prescribing
practice.It is evidenced that u neet integrated initiatives to improue
the situation eg distribution of prescribing/dispensing
guidelines.But passive distribution is not enough, it need to be
coupled with face to face supervision, peer review, performance
audits, regulatory inspections etc.But also One thing i have learnt
is that there is a need to incorporate P-medicine concept in
pharmacy/medicine degree curricula.
Another challenge we should address is poverty and illiteracy among
patients as there are evidence showing these two issues increase
irrational medicine use.This can be achieved by promoting free service
at point of delivery, social insurance and active public education.I
recommend a book by Chetley et al titled "how to improve the use of
medicines by consumers" 2007 edition. You can order it from WHO.

Mwemezi Ngemera, MA Health Mgt, Planning & Policy; BPharm
Ass. ADDO* Coordinator
Tanzania Food & Drugs Authority
Ministry of Health & Social Welfare
Dar es salaam
Tel +255 713 134030
E-mail: <ngemera@gmail.com>

*ADDO = Accredited Drugs Dispensing Outlets ( a National Public
Private Partnership Program aimed at improving access to quality
medicines and pharmaceutical services in rural and peri-urban areas)