Background
Method
Study design and setting
Study population
Development and validation of research instrument
Label | |
• It must present, legible and clean | |
• It must state the name, the strength and actual quantity of drug | |
• Instructions should be clear and understandable | |
• Medicines should have been dispensed within the time frame its remain efficacious. | |
Container | |
• The container should be original, intact and clean | |
• There should only be one product within the container | |
Expiry | |
• The expiry date should be found and should not be exceeded. | |
Product Integrity | |
• The medicine should be easily identified.(especially if clear liquid or loose white tablets) | |
• The product should be whole, clean with no visible deterioration (eg, no broken tablet) | |
Storage | |
• The medicine must be stored according to manufacturer’s recommendations |
Data collection & analysis
Results
Demographic and clinical characteristics of inpatients
Availability of PODS
Assessment of the quantity, quality and extent of use of PODs
Number of PODs per in-patient | Number of participants, N (%) |
---|---|
1 | 55 (18.3) |
2 | 71 (23.7) |
3 | 56 (18.7) |
4 | 23 (7.7) |
5 | 18 (6) |
More than 5 PODs | 47 (15.7) |
Finished before admission | 30 (10) |
Total | 300 (100) |
Components | Number PODS | ||
---|---|---|---|
PODs available at the hospital N (%) | PODs made available at the hospital based on request from the researcher N (%) | ||
Label present on the container of PODs | Yes, complete | 254 (30.1) | 155 (18.3) |
Yes, incomplete | 203 (24) | 125 (14.8) | |
No | 67 (7.9) | 41 (4.9) | |
Instruction for use | Legible | 247 (29.2) | 151 (17.9) |
Illegible | 277 (32.9) | 170 (20.1) | |
PODs clean and intact | Yes | 500 (57.2) | 307 (36.3) |
No | 24 (2.8) | 14 (4.9) | |
Expiry date identified | Yes | 467 (39.5) | 286 (33.8) |
No | 57 (6.7) | 35 (4.1) | |
PODs expired | Yes | 38 (4.5) | 24 (2.8) |
No | 453 (53.6) | 277 (32.9) | |
Not Sure | 33 (3.9) | 20 (2.4) |
Pharmacy staff survey
Variables | Strongly agree N (%) | Agree N (%) | Uncertain N (%) | Disagree N (%) | Strongly disagree N (%) | MEDIAN (IQR) |
---|---|---|---|---|---|---|
Patient having different brands of the same medicines | 62 (51) | 37 (31) | 4 (3) | 17 (14) | – | 1 (1.00) |
Inadequate time for PODs assessment at the ward | 21 (17) | 57 (47) | 19 (16) | 19 (16) | 5 | 2 (1.00) |
Lack of POD Policy in the hospital | 28 (23) | 54 (45) | 33 (27) | 6 (5) | – | 2 (1.00) |
Inadequate skills for staff for the assessment of PODs in in-patients | 10 (8) | 45 (37) | 10 (8) | 32 (26) | 24 (20) | 3 (2.00) |
It must be a shared responsibility amongst the pharmacy staff | 41 (34) | 58 (48) | 12 (10) | 10 (8) | – | 2 (1.00) |
Patients feel they should always be given new medicines | 19 (16) | 50 (41) | 21 (17) | 30 (25) | – | 2 (2.00) |
Illegible instructions on label | 44 (36) | 50 (41) | 20 (17) | 7 (6) | – | 2 (1.00) |
Difficulty in examining the expiry dates of PODs without original packages. | 44 (36) | 57 (47) | 8 (7) | 12 (10) |
–
| 2 (1.00) |
Inadequate staff to assess PODs of all in-patients | 40 (33) | 36 (30) | 20 (17) | 25 (21) | – | 2 (2.00) |
The illiteracy level of in-patients/carers | 43 (36) | 32 (26) | 25 (21) | 17 (14) | 4 | 2 (2.00) |
Inadequate education/ counselling to patients to bring their PODs when coming to the hospital | 45 (37) | 53 (44) | 11 (9) | 12 (10) | – | 2 (1.00) |
Hospitals PODs Management system and policy
When patients are transferred from other hospitals they bring their medicines along WN 1.Some patients with chronic illness also bring their medicines from home when they are on admission CP 2
‘The prescriber often states in the patient’s folder that the patient has the medicine and it should be continued. When PODs are stopped relatives are asked to take them home or it is kept in either the patients’ medicine box or in the left over box on the ward’. WN1
‘There is no laid down criteria for the assessment of PODs. When the prescriber states in the patients’ folder that PODs should be given the medicines are served with no assessment’. WN2
‘The pharmacy department does not often manage patients own drugs available on the ward. The pharmacist does not access the quality of these medicines and also the pharmacy department does not dispose of unused PODs. Medicines prescribed on the ward are often submitted to the pharmacy to be dispensed’. CP1
‘There is no guideline for the management of patients own drugs at the hospital. Patients bring their medicines to the hospital at their own discretion. Patients admitted on the ward are rarely asked to bring their medicines from home’. CP2*WN: WARD NURSE CP: CLINICAL PHARMACIST.