Purchasing Medications without Prescriptions, using Erroneous and Expired Prescriptions in Two Selected Community Pharmacies in Sri Lanka

Abstract

Background

A valid prescription with specified standards should be used to purchase most medicinal drugs. However, these rules are often violated in community pharmacies (CP).

Objective

The objectives of this study were to study the purchase of prescription only medicine (POM) without prescriptions, use of expired prescriptions and incomplete prescriptions in CPs in a selected locality of Sri Lanka.

Method

An observational study was conducted in two CPs in a semi urban area, in Galle, Sri Lanka. Purchasing behavior and quality of prescriptions were observed.

Results

A total of 1939 occurrences of purchasing medicines were observed. Of all purchases, 902 (46.5%) were done without a prescription. Purchase of POM without a prescription occurred in 691 (35.6%) instances. Antibiotics were the most purchased POM without a prescription (22.4%), followed by anti-hypertensives (18.2%). Common antibiotics purchased without a prescription were amoxicillin and co-amoxiclav. From the total prescriptions used in purchasing (1037), 426 (41.0%) were unsuitable for use in purchasing due to expired duration of the drug regimen and lack of date or duration of the regimen. From all prescriptions with date and duration mentioned (824), 351 (42.6%) were refilled (not buying for first time) and 212 (60.4%) refilled prescriptions were invalid as their regimen durations were already expired.

Conclusions

More than one third of purchases occurring in the CPs studied included purchase of POM without prescription. Many prescriptions were unsuitable to purchase medicine due to expired duration of the drug regime and incomplete prescription without duration or date. Refilling of prescription was done mainly using expired prescriptions.