MGHD 2018

Introduction: One of the major consequences of irrational dispensation of antimalarial and antibiotic drugs is the development of drug resistance. Antimalarial and oral antibiotics in Rwanda are prescription only medicines; therefore they should be exclusively dispensed under medical prescription. Factors underlying dispensation of antimalarial and antibiotics without medical prescription in Rubavu retail pharmacies were unknown. Objective: The aim of this study was to determine the factors underlying dispensation of antimalarial and antibiotics without a prescription in Rubavu retail pharmacy by February 2018. Methods: This was a descriptive cross-sectional study, conducted in the 15 retail pharmacies within Rubavu district from December 2017 to February 2018. Data was collected in two phases. The first phase was direct participant observation in order to measure the percentage of antimalarial and antibiotics that were requested without medical prescription by pharmacy clients. The second phase was a self-administered questionnaire in order to understand the dispensing practices and reasons for dispensing of antimalarial and antibiotics without a prescription. Results: The study showed that the 66% of antimalarial and 76% of antibiotics requested were without medical prescription. 77.5% and 90.0% of pharmacy healthcare providers reported to recommend respectively antimalarial and antibiotics. With regards to dispensing incomplete doses of antimalarial and antibiotics, findings from this study showed that 42.5% and 57.5% of respondents reported to dispense less than full course of therapy of antimalarial and antibiotics, respectively. With regards to barriers to good dispensing practice, 52.5% of participants reported that pharmacy management encourages pharmacy health workers to dispense regardless of the prescription, whereas 87.5% reported that there is a culture of self-medication and self-diagnosis in the region. In addition to that half of participants reported that dispensers are influenced by patients’ requests. Conclusion: The study highlighted a high percentage of both antimalarial and antibiotic drugs requested without medical prescriptions. Education about good pharmacy practices, enforcement of regulation concerning retail pharmacy ownership and availability of regular inspection are required to improve retail pharmacy dispensing practice.