Regular inspection and committing major malpractices: Case of Pakdasht pharmacies
AbstractBackground: It is necessary to regulate the pharmacies’ services to maintain their qualities for providing services to patients. One side that should be considered is to prevent pharmacy malpractices. Depending on the types and recurrences of illegal acts, regulatory affairs and enforcements could reduce malpractices in health care providers. The aim of this study was to evaluate the efficacy of pharmacy inspection. Method: In this study, we evaluated the efficacy of pharmacy inspection on preventing probable malpractices. Data were collected from inspection forms provided by Vice-Chancellor’s Office in Food and Drug Supervision in Shahid Beheshti University of Medical Sciences and were filled by inspectors between January 2013 and April 2014. Seven major illegal acts are considered in this study including pharmacist absences during the pharmacy opening hours, delivery of Non Prescription Drugs (NPDs) without pharmacist supervision, existence of expired drugs in pharmacy, existence of counterfeit drugs or cosmetics in pharmacy, existence of any illegal narcotic or amphetamine drugs without Drug-Sale-License, inappropriate drug storage condition, and insufficient consideration in Galenic formulation. The inspections were assessed in all 26 private pharmacies in Pakdasht, Tehran, Iran. Results: The results showed that the scores of second inspection in quantitative assessment became better than the first one. The average score of existence of illegal drugs in the second inspection was soared to 89.92 from 58.11 in the first inspection. According to the qualitative assessment, the number of malpractices, except delivery of prescription drugs and inappropriate storage condition had decreased entirely from the first to the last inspection. Existence of illegal narcotics and amphetamines in pharmacy reduced from 13% to zero. Conclusion: Pharmacy inspection could reduce malpractices if it is performed routinely and the penalties are strict and suitable.
Dadfar, H. and S. Brege. “Differentiation by improving quality of services at the last touch point: The case of Tehran pharmacies.” International Journal of Quality and Service Sciences. (2012) 4(4): 345-63.
Bennett, S., G. Dakpallah, P. Garner, L. Gilson, S. Nittayaramphong, B. Zurita, and A. Zwi. “Carrot and stick: state mechanisms to influence private provider behavior.” Health Policy Plan. (1994) 9(1): 1-13.
Giusti, D., B. Criel, and X. De Béthune. “Viewpoint: public versus private health care delivery: beyond the slogans.” Health Policy Plan (1997) 12(3): 193-98.
Kumaranayake, L. “The role of regulation: influencing private sector activity within health sector reform.” J. int. dev (1997) 9(4): 641-49.
Nittayaramphong, S.-n. and V. Tangcharoensathien. “Thailand: private health care out of control?” Health Policy Plan (1994) 9(1): 31-40.
Stenson, B., L. Syhakhang, B. Eriksson, and G. Tomson. “Real world pharmacy: assessing the quality of private pharmacy practice in the Lao People’s Democratic Republic.” Soc sci med (2001) 52(3): 393-404.
Van Lerberghe, W., W. Ammar, R. El Rashidi, A. Sales, and A. Mechbal. “Reform follows failure: I. Unregulated private care in Lebanon.” Health Policy Plan (1997) 12(4): 296-311.
"Iran Pharmacy Bylaw" [accessed on May,22, 2014]. Available from: http://behdasht.gov.ir/index.aspx?siteid=1&pageid=12961&newsview=2983.
Butt, Z. A., A. H. Gilani, D. Nanan, A. L. Sheikh, and F. White. “Quality of pharmacies in Pakistan: a cross-sectional survey.” Int J Qual Health Care (2005) 17(4): 307-13.
Beckerleg, S., G. Lewando-Hundt, M. Eddama, A. El Alem, R. Shawa, and Y. Abed. “Purchasing a quick fix from private pharmacies in the Gaza Strip.” Soc sci med (1999) 49(11): 1489-500.
Rabbani, F., F. Cheema, N. Talati, S. Siddiqui, S. Syed, S. Bashir, L. Zuberi, A. Shamim, and Q. Mumtaz. “Behind the counter: pharmacies and dispensing patterns of pharmacy attendants in Karachi.” J Pak Med Assoc (2001) 51(4): 149-53.
Saradamma, R. D., N. Higginbotham, and M. Nichter. “Social factors influencing the acquisition of antibiotics without prescription in Kerala State, south India.” Soc sci med (2000) 50(6): 891-903.
Syhakhang, L., B. Stenson, R. Wahlström, and G. Tomson. “The quality of public and private pharmacy practices.” EUR J CLIN PHARMACOL (2001) 57(3): 221-27.
Hanif, M., M. R. Mobarak, A. Ronan, D. Rahman, J. J. Donovan Jr, and M. L. Bennish. “Fatal renal failure caused by diethylene glycol in paracetamol elixir: the Bangladesh epidemic.” BMJ (1995) 311(6997): 88.
Kelesidis, T., I. Kelesidis, P. I. Rafailidis, and M. E. Falagas. “Counterfeit or substandard antimicrobial drugs: a review of the scientific evidence.” J Antimicrob Chemother (2007) 60(2): 214-36.
Menkes, D. B. “Hazardous drugs in developing countries.” BMJ (1997) 315(7122): 1557.
Newton, P., S. Proux, M. Green, F. Smithuis, J. Rozendaal, S. Prakongpan, K. Chotivanich, M. Mayxay, S. Looareesuwan, and J. Farrar. “Fake artesunate in southeast Asia.” The Lancet (2001) 357(9272): 1948-50.
Pecoul, B., P. Chirac, P. Trouiller, and J. Pinel. “Access to essential drugs in poor countries: a lost battle?” Jama (1999) 281(4): 361-67.
Po, A. L. W. “Too much, too little, or none at all: dealing with substandard and fake drugs.” The Lancet (2001) 357(9272): 1904.
Roy, J. “The menace of substandard drugs.” World health forum (1994) 15(4):406-7
Shakoor, O., R. Taylor, and R. Behrens. “Assessment of the incidence of substandard drugs in developing countries.” TROP MED INT HEALTH (1997) 2(9): 839-45.
Taylor, R., O. Shakoor, R. Behrens, M. Everard, A. Low, J. Wangboonskul, R. Reid, and J. Kolawole. “Pharmacopoeial quality of drugs supplied by Nigerian pharmacies.” The Lancet (2001) 357(9272): 1933-36.
Wondemagegnehu, E. 1999. “Counterfeit and substandard drugs in Myanmar and Viet Nam.” Geneva, World Health Organization.
Afu, S. “Incidence of substandard drugs in developing countries.” TROP MED INT HEALTH (1999) 4(1): 73.
Lancet, T. “Quality control and essential drugs.” The Lancet (1997) 350(9078): 601.
Verduin‐Muttiganzi, R. and G. Verduin‐Muttiganzi. “Assessment of the incidence of substandard drugs in developing countries.” TROP MED INT HEALTH (1998) 3(7): 602-02.
Allan, E. and K. Barker. “Fundamentals of medication error research.” Am J Health Syst Pharm (1990) 47(3): 555-71.
Lisby, M., L. P. Nielsen, and J. Mainz. “Errors in the medication process: frequency, type, and potential clinical consequences.” Int J Qual Health Care (2005) 17(1): 15-22.
Bennett, S., J. D. Quick, and G. Vela´squesz.. “Public-private roles in the pharmaceutical sector. Implications for equitable access and rational drug use.”(1997) world health organization. [accessed on December 13, 2014]. Available from: URL: http://apps.who.int/medicinedocs/pdf/whozip27e/whozip27e.pdf
Cederlof, C. and G. Tomson. “Private pharmacies and the health sector reform in developing countries-professional and commercial highlights.” J Soc Admin Pharm (1995) 12: 101-11.
Vela´squesz, G., Madrid, Y., & Quick, J. “Health reform and drug ﬁnancing. Selected topics. Health economics and drugs.” DAP Series (1998) No. 6. [accessed on December 13, 2014]. Available from: URL: http://apps.who.int/medicinedocs/en/d/Jwhozip33e/
"Tazirat organization- drug and medicine section" [accessed on June 2, 2014]. Available from: http://www.tazirat.gov.ir/default-81.aspx.
Kloner, R. A. “Pharmacology and drug interaction effects of the phosphodiesterase 5 inhibitors: focus on α-blocker interactions.” Am J Cardiol (2005) 96(12): 42-46.