Authors
1 Department of Clinical Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
2 Student Research Committee, International Branch, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract
Objective: In this study, we aimed to assess knowledge, attitude, and practice of
community pharmacists toward administration of over‑the‑counter (OTC) antidiarrheal
drugs in our city pharmacies, Shiraz, Iran.
Methods: In this descriptive cross‑sectional study, 90 pharmacies among 128 pharmacies
in our city were randomly chosen. The study was designed into two phases: A standard
questionnaire to determine the level of knowledge and attitude of pharmacists and a
simulated client method to evaluate practice among them. An educational pamphlet was
then given to the pharmacists. One month later, knowledge, attitude, and performance
of studied pharmacists were evaluated again using the same method.
Findings: Our results showed that an average consultation time by female pharmacists
was considerably more than male pharmacists (P < 0.001). Before intervention, only
37.8% of pharmacists performed appropriately by prescribing the proper medicine
while this increased to 58.44% after intervention. The average score of pharmacists’
knowledge was statistically increased (P < 0.001) and the pharmacists’ performance
was significantly improved (P < 0.001) after the educational intervention. In related
to the attitude, pharmacists’ tendency toward prescribing oral rehydration salt
solutions (ORS)(P < 0.001) and their belief about the great effect of ORS on the treatment
of diarrhea increased significantly after the intervention.
Conclusion: It is concluded that training programs such as educational pamphlets and
continuing educational seminars may play important roles in increasing pharmacists’
knowledge and therefore improving their performance in prescribing OTC medicines.
Keywords
Pharmacists’ readiness to assess consumers’ over‑the‑counter
product selections. J Am Pharm Assoc (Wash) 2000;40:487‑94.
2. FDA CDER Handbook: Over‑the‑Counter Drug Products.
Archived from the Original on May 12, 2009. Available from:
http://www.fda.gov/downloads/AboutFDA/CentersOffices/
CDER/UCM148055.pdf [Last retrieved on 2007 Oct 9].
3. Hughes L, Whittlesea C, Luscombe D. Patients’ knowledge
and perceptions of the side‑effects of OTC medication. J Clin
Pharm Ther 2002;27:243‑8.
4. Pray WS. Nonprescription Product Therapeutics. 1st ed.
Baltimore, MD: Lippincott Williams & Wilkins; 1999. p. 4‑14.
5. Schulke DG. American Pharmaceutical Association review of
literature on prescription to over‑the‑counter drug switches.
Clin Ther 1998;20 Suppl C:C124‑33.
6. Das BP, Deo SK, Jha N, Rauniar GP, Naga Rani MA.
Knowledge, attitudes and practices (KAP) regarding the
management of diarrhea by pharmacists and licensed drug
sellers in eastern Nepal. Southeast Asian J Trop Med Public
Health 2005;36:1562‑7.
7. Behrman RE, Kliegman RM, Nelson WE, editors. Infections
disease. In: Nelson text book of pediatrics. 14th edition,
Philadelphia: W. B. Saunders co.; 1992.
8. SnyderJD, Merson MH. The magnitude of the global problem
of acute diarrhoeal disease: A review of active surveillance
data. Bull World Health Organ 1982;60:605‑13.
9. The World Health Organization. The Treatment of Diarrhea:
A Manual for Physicians and Other Senior Health Workers;
2005. Available from: http://www.whqlibdoc.who.int/
publications/2005/9241593180.pdf. [Last accessed on
2010 Sep 20].
10. Saengcharoen W, Lerkiatbundit S. Practice and attitudes
regarding the management of childhood diarrhoea
among pharmacies in Thailand. Int J Pharm Pract
2010;18:323‑31.
11. Ogbo PU, Aina BA, Aderemi‑Williams RI. Management of
acute diarrhea in children by community pharmacists in
Lagos, Nigeria. Pharm Pract (Granada) 2014;12:376.
12. Zargarzadeh A, Mostafavi SA, Chamanara M. Community
pharmacists Performance in Management of Cough, Diarrhea
and Obesity Using Over-the-counter Medications. J Isfahan
Med Sch 2013;31:161-79.
13. True Random Number Service. Random Number Generator.
Available from: http://www.random.org. [Last cited on
2012 Feb 23].
14. Walker PC. Diarrhea. In: Krinsky DL, Berardi RR. Handbook
of Nonprescription Drugs. 14nd ed. Washington, DC: American
Pharmacist Association; 2004. p. 405‑32.
15. D'Arcy PF. The treatment of acute diarrhea information
for pharmacists. Geneva: O. Diarrheal Disease control
programme, WHO, 1997.
16. Lamsam GD, Kropff MA. Community pharmacists’
assessments and recommendations for treatment in four case
scenarios. Ann Pharmacother 1998;32:409‑16.
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