An Educational Intervention to Strengthen Community Pharmacy Practice in Nepal.

In Nepal, community pharmacies serve as the primary source of medical care. The aim of the current study was to evaluate the effect of an educational intervention on knowledge and practice of dispensing, prescription handling and patient counseling among community pharmacists working in 3 districts (Kathmandu, Lalitpur and Bhaktapur) of Nepal. A quasi-experimental pre-post interventional study was conducted in 123 community pharmacies located in Kathmandu, Bhaktapur, and Lalitpur districts of Nepal. The research questionnaire was developed according to national and international good pharmacy practice guidelines. A structured questionnaire with mainly closed-ended and a few open-ended questions, exploring the knowledge and practice of community pharmacists in the 3 areas mentioned previously was prepared. Demographic information was also collected. The pre-tested questionnaires were completed by the community pharmacy in charge from the selected pharmacy. This data was considered as the pre-intervention data. Education sessions on good pharmacy practice were provided to all selected community pharmacists by expert pharmacists. Three weeks following the educational intervention, post-intervention data was collected at the same pharmacies. The percentage of pharmacies chosen were Kathmandu (48.8%), Lalitpur (30.9%), and Bhaktapur (20.3%). Seventy-four percent of respondents were Diploma in Pharmacy, 21.1% were bachelor's in pharmacy. The major problems faced by the pharmacists during dispensing were inadequate instructions (30.1%), followed by missing duration of therapy (24.4%) and unavailable drugs (22.0%). Other problems included dosage form errors (15.4%), illegible prescriptions (13.0%), dosing errors (13.0%), and drug interactions (13.0%). The educational intervention had a positive impact on both knowledge and practice scores among pharmacists, irrespective of their qualification level. The intervention also significantly improved pharmacists' knowledge and practice scores regardless of gender. The educational intervention improved both knowledge and practice scores in counseling, prescription handling and dispensing. Similar studies in other districts and provinces are required.