Source: Daily Nation
5th March 2011
Most pharmacies in Kenya sell medicine across the counter without asking for a prescription, a new survey shows.
This happens despite the fact that the Pharmacy and Poisons Board has circulated a list of drugs that should not be sold without a prescription.
A study commissioned by Synovate to establish the incidence of abuse of prescription type drugs reveals a worrying trend.
A total of 203 pollsters visited various pharmacies in all the eight provinces and sought to buy a specific brand of antibiotic which should normally be sold only on prescription.
Synovate used the “mystery shopping technique” and almost three quarters (73 per cent) of the pharmacies which sold the medicine did not ask for a prescription.
Nine per cent of the pharmacies asked for a prescription but went ahead and sold the antibiotic anyway even though it was not produced.
Only 18 per cent asked for prescriptions and refused to sell the drug without one being produced.
Synovate managing director George Waititu told Saturday Nation that he was surprised at how widespread the problem was.
The study was commissioned following increasing cases of self-medication.
“I think the responsible ministry needs to do more to educate the public on the dangers of self-medication and the public needs to take the dangers associated with this seriously.”
Pharmacies insist on prescriptions for some medicines because they should not be taken by patients with certain conditions and could have serious side effects which can even lead to death.
This class of medicine is referred to as “contra-indicated”.
For example, a pregnant woman is not allowed to take Doxycycline, advises Dr Boniface Chitayi, who operates from Mbagathi hospital.
A doctor also stipulates a certain dosage to be taken for an appropriate number of days, depending on the condition, he said.
“If the proper dosage is not followed a patient could develop antibiotic resistance. This is because when bacteria is half exposed to the medicine it changes its structure and cannot be destroyed by the same drug in future,” said Dr Chitayi.
He said that people resort to self-medication when they have no access to a doctor or have no money for consultation fees.
“Sometimes pharmacists sympathise with Kenyans, especially in cases where a child has pneumonia. But I know most bigger pharmacies with qualified staff follow the rules,” he said.
He said such problems appear prevalent among poorly educated people.
Dr Chitayi, who is also secretary general of the Kenya Medical Practitioners, Pharmacists and Dentists Union, urged pharmacies to be more responsible in dispensing drugs.
He said there were drugs that patients can purchase across the counter which include pain killers like Paracetamol, Diclofenac, Brufen, Piriton and anti-malarials.
“However, others like Tramadol, Gabatentin and Carbamazepine are commonly bought over the counter but that is wrong. Usually all antibiotics including Amoxil and Tetracycline should not be sold without a prescription,” he told Saturday Nation.
Easy access to these medicines is aggravating antibiotic resistance among Kenyans, contributing to spiralling health costs as the country searches for second line drugs to when first line drugs become ineffective in treating diseases.
Medical experts cite a number of reasons why Kenyans self-medicate, top of which is the high cost of health care. Many people do not have medical insurance.
“Sometimes, some people go online to establish what they are suffering from and buy the medicine proposed on the Internet. The problem is the situation might be different,” said Dr Chitayi.
Confronted with a choice of paying for a doctor’s consultation fee or walking into a pharmacy and just asking for the drugs they believe will cure them, many Kenyans would opt for the latter.
Some, it emerged, just want to take shortcuts such as imagining that the same drugs that cured a previous medical condition will cure a problem with similar symptoms.
“Addiction to prescription drugs and lack of knowledge that a prescription is mandatory for certain types of drugs could also be factors contributing to this trend,” said Synovate’s Mr Waititu.
While ordinary citizens may lack knowledge and be forgiven for the action, one would not expect that pharmacists who are qualified enough to know better to simply turn a blind eye to make more money.
“What many Kenyans may not be aware of is that buying these drugs without a prescription is drug abuse,” said the Synovate managing director.
However, pharmacies alone cannot be blamed for incorrect usage of medicines.
The medical establishment, the Pharmacy and Poisons Board and the patients themselves must share the responsibility.
They should tackle the proliferation of counterfeit drugs, poor prescription practices and a perceived lack of regulation or guidelines.
Lack of regulation, the survey indicates, is actually fuelling the growth of resistance to these much-needed medicines.