Nicotine Patch Dispensing Behaviour of Pharmacists in Drugstores: Chiang Mai, Thailand.

Author(s) Suntheep Batra1
Affiliation(s) 1Department of Pharmaceutical Care, Faculty of Pharmacy, Payap University, Chiang Mai, Thailand.
Country - ies of focus Thailand
Relevant to the conference tracks Chronic Diseases
Summary Community pharmacists in Chiang Mai, Thailand had good knowledge of, but extremely sub-optimal dispensing behaviors of nicotine patches. This is particularly in relation to advising specific usage instructions of the nicotine patch and assessing nicotine dependence and willingness of smokers to quit. This information will be useful to guide and raise the awareness of community pharmacists in dispensing nicotine patches and providing counselling for smoking cessation.
Background Tobacco use is the most important public health problem globally, and a risk factor for many acute or chronic diseases which are the leading preventable cause of death in the world. In Thailand, 14.3 million people (27.2%) are current tobacco users, and 12.5 million people (23.7%) currently smoked tobacco. Smoking killed 42,000 Thai smokers every year or 4.7 deaths in every hour. Pharmacotherapy is one of the success keys to smoking cessation. Community pharmacists can dispense these medicines without prescription in drugstores in Thailand and also have an important role in smoking cessation counselling. Thus, the pharmacists must have good knowledge of the usage instructions of these medicines, especially nicotine gum and patch which require special technique usage instructions, as well as counselling skills in order to improve drug therapy and smoking cessation effectiveness. The pharmacists’ behavior in dispensing nicotine gum has been studied before in Thailand, but the interpretation of the study was limited by small sample size. Furthermore, no data on the nicotine patch dispensing behavior of pharmacists in drugstore are available in Thailand. Therefore, it is important to evaluate nicotine patch dispensing behaviors and knowledge of community pharmacists.
Objectives The objectives of this study were to evaluate nicotine patch dispensing behaviors and knowledge of community pharmacists in Chiang Mai, Thailand.
Methodology In this cross-sectional descriptive study, 54 pharmacists who practiced in drugstores in Muang district, Chiang Mai, were enrolled by purposive random sampling. Pharmacists who practiced in drugstores where nicotine patches were not available, were excluded. The pharmacists’ behaviors in dispensing nicotine patches were observed by the mystery client technique. After a month, pharmacists’ knowledge about nicotine patch was assessed by the self-completion knowledge questionnaire. Data were collected between 1 July 2012 and 30 September 2012, and were analyzed by descriptive statistics, expressed as median (IQR) or n (%), as appropriate.
Results The results found that the median score of pharmacists’ behaviors about dispensing nicotine patches was 7.0 (4.0 – 12.0) from a total of 25. Choosing the appropriate dosage of a nicotine patch for smokers (94.4%) was the most frequently practiced behavior of pharmacists during the dispensing of a nicotine patch. However, advising about usage instructions of nicotine patch, and assessing nicotine dependence and willingness to quit of smokers were practiced by less than 20.0% of pharmacists. In term of knowledge, 48 pharmacists cooperated with the study questionnaire (response rate 88.9%). The median score of pharmacists’ knowledge about nicotine patch was 10.0 (9.0 – 12.0) from a total of 14. Almost every pharmacist (91.7%) knew about adverse drug reactions and prevention of these reactions from the nicotine patch, but most of them (72.9%) didn’t know about usage instructions of the nicotine patch.
Conclusion This study has demonstrated that the community pharmacists in Chiang Mai, Thailand had a good knowledge, but extremely sub-optimal dispensing behaviors of nicotine patches, especially in advising specific usage instructions of nicotine patch and assessing nicotine dependence and willingness to quit of smokers.

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