Prospective encounter study of the degree of adherence to patient care indicators related to drug dispensing in Health Care facilities: A Sri Lankan perspective

Abstract

The World Health Organization-recommended patient care indicators in Government Hospitals were assessed in 422 patients attending the Outpatient Department in selected hospitals of the Galle district in Southern Province. The average dispensing time (ADT), percentage of drugs actually dispensed (PDAD), percentage of drugs adequately labeled (PDAL) and patient's knowledge on correct dosage (PKCD) were compared in these selected teaching hospitals (TH), general hospitals (GHs) and district hospitals (DHs) in Galle. ADT in DH (1.16 min) and GH (1.07 min) were high when compared with ADT in TH (0.81 min). PDAD was 100% in DH, 97.79% in GH and lowest in TH (94.64%). PDAL was highest (22.66%) in TH, 17.57% in GH and lowest in DH (1.57%). PKCD was 100% in GH and lowest in DH (0%) and only 50% in TH in Galle district. We noted that there was a significant difference in ADT in all three categories (P < 0.05). We noted that dispensers spend only a short dispensing time and showed a tendency for dispensing errors. We found that PDAL was very low in all hospitals but PDAD was significantly high. Even though the ADT was high in DH, PKCD was 0% due to negligence in dispensing practices. We also noted a 100% PKCD only in GH due to the practice of a well-prepared correct labeling system in GH. We noticed that these patients were provided drugs with inadequate labeling and that patients had only a poor knowledge about the drug administration schedule. We conclude that there was a low dispenser-patient ratio in all three hospitals and that there was a need for an implementation plan for proper dispensing techniques by introducing a well-prepared drug labeling system in a printed format.

Keywords: Drug use pattern; essential drug list; polypharmacy; prescriber errors; rational prescription.

Figure 1

Average dispensing time in minutes (ADT) in different hospitals using ANOVA. ADT in different hospitals were 0.18 min in teaching hospitals (TH), 1.07 min in general hospitals (GH) and 1.16 min in district hospitals (DH), respectively. There a significant difference between these means

Figure 2

Percentage of drugs actually dispensed (PDAD) at the different hospitals using ANOVA. PDAD results indicate 94.64% in teaching hospitals (TH), 97.79% in general hospitals (GH) and 100% in district hospitals (DH), respectively

Figure 3

Percentage of drugs adequately labeled at different hospitals. Values are given as 22.16% in teaching hospitals (TH), 17.57% in general hospitals (GH) and 1.57% in district hospitals (DH)

Figure 4

Results showing that patient's knowledge on correct dosage (PKCD) were different in different health care facilities. Changes in PKCD as shown above in different hospitals were 50% in teaching hospitals (TH), 100% in general hospitals (GH) and 0% in district hospitals (DH)