Inappropriate Dispensing Practices for Antimalarials in the La-Nkwantanang Madina Municipality, Greater Accra-Ghana

Background: Empirical research and interventions on dispensing practices lag behind, partly because of the complexity of dispensing practices and the dearth of available data at the community level. Few studies conducted, focus on dispensing practices in hospital pharmacies. The primary purpose of this study is to investigate predictors of dispensing practices for antimalarials in community pharmacies.

Method: Sixty-one randomly selected community pharmacies were involved in the cross-sectional analytic study. Data were collected from 230 clients, who had been dispensed antimalarials by 106 dispensers. Frequencies, chi square test and logistic regression analysis were conducted, accounting for clustering.

Results and Discussion: Over 70% of the dispensers were medicine counter assistants. The mean age of dispensers was 30.4 years (SD 8.8). More than half of the clients (52.2%) were given appropriate dispensing information on antimalarial use. Over 88.0% of clients were advised to complete the full course. However, the 8-hour loading dose principle for Artemether/Lumefantrine was not explained to 88.3% of the clients. Most clients, 152 (66.1%), were dispensed antimalarials without malaria tests. Dispensers with more than 10 years’ experience were less likely to dispense ACTs appropriately (AOR = 0.08, 95%CI = 0.08 0.01-0.81 p-value=0.032) while pharmacy interns were 24 times more likely (AOR = 24.0, 95%CI = 1.18-501.90 p-value=0.039) to dispense ACT’s appropriately compared to pharmacists. 

Conclusion: Dispensing practices for antimalarials is sub-optimal. Action-oriented update on the knowledge and skills of dispensers, targeting those with more than 10 years’ work experience is recommended. Education should focus on adherence and compliance to WHO’s Test, Treat and Track initiative to reduce the burden of antimalarial drug resistance.