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Importance and Awareness of the Good Pharmacy Practice from Drugstore Clients’ Perspectives

Authors:
Pantira Parinyarux at Chulalongkorn University
Pantira Parinyarux
Kitiyot Yotsombut at Chulalongkorn University
Kitiyot Yotsombut
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Abstract

Objective: To explore the importance and awareness of the Good Pharmacy Practice (GPP) standard among drugstore clients. Methods: The study was a cross-sectional survey using an online questionnaire consisting of 3-point scales for importance and awareness of the GPP (very important, not very important, and not important for importance scale and fully aware, partially aware, and not aware for awareness scale). The subjects were clients using drugstore services in the previous two years. The survey through the Google Form conducting during June 20th and July 20th 2021 was distributed in Facebook public groups and Line public groups. Results: There were 388 clients completing the questionnaire. Majority of subjects were female (76.3%) with a median age of 29 years (IQR: 23 – 40 years). The proportion of clients rating “critical defect” standards (CDS) in the GPP as very important was 85.1-93.1% for the CDS in the pharmacy practice domain, and 59.6 - 89.7% for the physical structure and equipment domain. The CDS with the highest proportion of clients rating as very important was "no expired medications were dispensed in pharmacy" (93.1%), while that with the lowest proportion rating as very important was "a weight scale and height ruler must be available" (59.6%). The CDS with the highest proportion of clients reporting as fully aware was "no expired medications were dispensed in pharmacy" (77.3%), and that with the lowest proportion was "pharmacy space must not be smaller than 8 square meters" (18.5%). However, the GPP items with the highest proportion of clients reporting as very important were not included in the CDS such as "before dispensing medication, pharmacists must obtain the relevant patient information" and "understandable labels of medications must be provided" (94.1 and 93.6% of clients, respectively). Conclusion: The CDSs in the pharmacy practice domain were considered important in the clients’ perspectives, but those on physical structure and equipment were considered having low importance. As a result, measures are needed to improve clients' awareness.
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

1, 2
1
2 

 (Good
Pharmacy Practice: GPP)  
GPP 3

2 20
- 20 2564 Google Form Facebook Line 
 388 76.3) 
29 23 – 40 GPP 
85.1 - 93.1  59.6 - 89.7 
93.1) 
 59.6) 
77.3) 8 18.5) 

94.1 93.6 GPP
 GPP 

  
: 10 2564, : 282564,: 62564
:  
10330 E-mail: kitiyot.y@pharm.chula.ac.th

2
Importance and Awareness of the Good Pharmacy Practice
from Drugstore Clients’ Perspectives
Pantira Parinyarux1, Kitiyot Yotsombut2
1Department of Social Pharmacy, Faculty of Pharmacy, Payap University
2Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University
Abstract
Objective: To explore the importance and awareness of the Good Pharmacy Practice (GPP) standard among
drugstore clients. Methods: The study was a cross-sectional survey using an online questionnaire consisting of 3-point
scales for importance and awareness of the GPP (very important, not very important, and not important for importance
scale and fully aware, partially aware, and not aware for awareness scale). The subjects were clients using drugstore
services in the previous two years. The survey through the Google Form conducting during June 20th and July 20th 2021
was distributed in Facebook public groups and Line public groups. Results: There were 388 clients completing the
questionnaire. Majority of subjects were female (76.3%) with median age of 29 years (IQR: 23 – 40 years). Proportion
of clients rating “critical defect” standards (CDS) in the GPP as very important was 85.1-93.1% for the CDS in pharmacy
practice domain, and 59.6 - 89.7% for physical structure and equipment domain. The CDS with the highest proportion
of clients rating as very important was "no expired medications were dispensed in pharmacy" (93.1%), while that with
the lowest proportion rating as very important was "a weight scale and height ruler must be available" (59.6%). The CDS
with the highest proportion of clients reporting as fully aware was "no expired medications were dispensed in pharmacy"
(77.3%), and that with the lowest proportion was "pharmacy space must not be smaller than 8 square meters" (18.5%).
However, the GPP items with the highest proportion of clients reporting as very important were not included in the CDS
such as "before dispensing medication, pharmacists must obtain the relevant patient information" and "understandable
labels of medications must be provided" (94.1 and 93.6% of clients, respectively). Conclusion: The CDSs in pharmacy
practice domain were considered important in the clients’ perspectives, but those on physical structure and equipment
were considered having low importance. As a result, measures are needed to improve clients' awareness.
Keywords: good pharmacy practice, drugstores, pharmacy clients, community pharmacy
Research article
 3

Good Pharmacy
PracticeGPP)  2535
International Pharmaceu
tical Federation: FIP) 2537
1) 



2546” 


2) 


GPP 

2556” 252557

8
252565
GPP (3)
GPP


2557” 
21
2
23

4) 
GPP 
critical defect) 


5)



2556” 

GPP) 36) 2557 -
2561GPP 1


GPP (7–13) 

GPP (14) 2562 - 2563GPP 
2
GPP 115)
GPP 





8


8, 9, 12)






16,17) 

 GPP 


GPP 


7 

GPP

GPP 
4


20  – 20
2564


30/2564)


18 
(18) 95


51.9(19)
384 

10-15

450 
(20) 
2 


(Google Form)
QR code 
 Facebook group LINE group 






2557(4,21)
GPP 3; 1) 
2) 
GPP3)  

(item-
objective congruence index: IOC) IOC 
 0.67 - 1

35 
Cronbach's alpha coefficient 0.96

3 

2 3 
GPP 28 
3 





IBM® SPSS® 




388 

76.3)29 
2340
5 310
58.8) (
30.7)
1)

52.1
(1)
72.5  
1 
GPP(2)

GPP

 5
1 (n=388)

, (

82 (21.1)

296 (76.3)

10 (2.6)
, (

180 (46.4)

147 (37.9)

22 (5.7)

20 (5.1)

17 (4.4)

2 (0.5)
, (

2 (0.5)

55 (14.2)

3 (0.8)

6 (1.5)

228 (58.8)

94 (24.2)
, (

119 (30.7)
 
109 (28.1)

51 (13.1)
 
47 (12.1)
 
21 (5.4)

41 (10.6)
 1
1
5 (3 - 10)
1:
596897851
931


93.1
91.5) 


59.6 
1. 

2)


185 634
54.9 – 77.3


77.3)2 

858.0)

37.4 2)



94.1

2.
GPP
6
2  GPP 

GPP








1 


348
(89.7)
33
(8.5)
7
(1.8)
246
(63.4)
95
(24.5)
47
(12.1)

342
(88.1)
35
(9.0)
11
(2.9)
210
(54.1)
109
(28.1)
69
(17.8)


342
(88.1)
36
(9.3)
10
(2.6)
236
(60.8)
85
(21.9)
67
(17.3)
30 

332
(85.6)
46
(11.8)
10
(2.6)
144
(37.1)
105
(27.1)
139
(35.8)
1 
304
(78.4)
64
(16.5)
20
(5.1)
166
(42.7)
98
(25.3)
124
(32.0)

250
(64.5)
115
(29.6)
23
(5.9)
137
(35.3)
106
(27.3)
145
(37.4)
8 
243
(62.6)
112
(28.9)
33
(8.5)
72
(18.5)
91
(23.5)
225
(58.0)

231
(59.6)
122
(31.4)
35
(9.0)
174
(44.8)
89
(22.9)
125
(32.3)
2


361
(93.1)
23
(5.9)
4
(1.0)
300
(77.3)
55
(14.2)
33
(8.5)

355
(91.5)
28
(7.2)
5
(1.3)
286
(73.7)
66
(17.0)
36
(9.3)


348
(89.7)
32
(8.2)
8
(2.1)
279
(71.9)
77
(19.8)
32
(8.3)


330
(85.1)
48
(12.4)
10
(2.5)
213
(54.9)
108
(27.8)
67
(17.3)

93.6  

 




 7


78.63)
GPP 
 (79.1) 





 
3)
3 GPP 

GPP










1 


305
(78.6)
60
(15.5)
23
(5.9)
179
(46.1)
98
(25.3)
111
(28.6)
2



347
(89.4)
33
(8.5)
8
(2.1)
296
(76.3)
62
(16.0)
30
(7.7)



333
(85.8)
46
(11.9)
9
(2.3)
254
(65.5)
87
(22.4)
47
(12.1)



332
(85.6)
44
(11.3)
12
(3.1)
189
(48.7)
85
(21.9)
114
(29.4)


324
(83.5)
55
(14.2)
9
(2.3)
174
(44.8)
126
(32.5)
88
(22.7)

6-8 

338
(87.1)
40
(10.3)
10
(2.6)
150
(38.6)
102
(26.3)
136
(35.1)


321
(82.7)
54
(13.9)
13
(3.4)
137
(35.3)
99
(25.5)
152
(39.2)


306
(78.9)
65
(16.8)
17
(4.3)
115
(29.7)
75
(19.3)
198
(51.0)




365
(94.1)
18
(4.6)
5
(1.3)
288
(74.2)
76
(19.6)
24
(6.2)
8
3 GPP 
 
GPP












363
(93.6)
17
(4.4)
8
(2.0)
307
(79.1)
52
(13.4)
29
(7.5)


346
(89.2)
34
(8.8)
8
(2.0)
242
(62.4)
99
(25.5)
47
(12.1)


345
(88.9)
35
(9.1)
8
(2.0)
244
(62.9)
90
(23.2)
54
(13.9)

337
(86.9)
43
(11.1)
8
(2.0)
280
(72.1)
55
(14.2)
53
(13.7)


329
(84.8)
47
(12.1)
12
(3.1)
226
(58.2)
91
(23.5)
71
(18.3)


316
(81.4)
61
(15.7)
11
(2.9)
211
(54.3)
98
(25.3)
79
(20.4)


305
(78.6)
65
(16.8)
18
(4.6)
150
(38.7)
99
(25.5)
139
(35.8)


GPP 

12 

2556
 GPP (4) 

GPP     


 GPP 
2 

80





59.6


8 

(22)



50  (12)




 GPP 


 9




GPP 
 (72.49







54.9 

44.8
GPP 







GPP

 

GPP 

 




 (23) 

 (16,24)
GPP 

GPP 

 


 
19


20-40
            


health literacy) 83










 GPP

GPP 

       
GPP 

GPP 


GPP 




GPP 
10




GPP 


1World Health Organization. Joint FIP/WHO guidelines
on good pharmacy practice: standards for quality of
pharmacy services. In: WHO Expert Committee on
Specifications for Pharmaceutical Preparations. New
York; 2011p.31023
2The Office of Community Pharmacy Accreditation
(Thailand). History of the community pharmacy
accreditation program [online]. 2019cited Feb 14,
2021Available from: papc.pharmacycouncil.org/ind
ex.php?option=aboutus&subpage=history.
3Ministerial Regulations on the permission and appro
val for drugstore type 1 license B.E. 25562013
online]. 2013cited Feb 14, 2021Available from:
www.fda.moph.go.th/sites/drug/Shared20Docume
nts/Law02Ministerial-regulations/001PDF.
4Vimolkittiphong S, Pantong M. Guideline to achieve
mandatory GPP regulation. Nonthaburi: Food and
Drug Administration; 2015
5Ministry of Public Health. Self-assessment document
based on Good Pharmacy Practice (GPP) assess
ment guidelines [online]. 2013cited Feb 14, 2021
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CUSTOMER EXPECTATION SURVEY ON THE COMPETENCY OF COMMUNITY PHARMACISTS AND FUTURE SERVICE
Article
Full-text available
  • Mar 2020
A survey was conducted in Thailand on customer expectations of community pharmacists’ competency and current and future community pharmacy service. A descriptive, cross-sectional questionnaire was used. A nationwide sample of nearly 300 pharmacy customers who entered pharmacies was asked to complete the questionnaire by a community pharmacist. A five-point Likert scale of expectation (1 = least agree to 5 = most agree) with open-ended questions was used. The response rate was 82.33% with the majority of pharmacy customers being female (61.90%). Most of them were company employees, had social security rights, and got services from pharmacies located in Bangkok. Purchasing medications for minor illnesses or treating symptoms was the main purpose of using pharmacy services. The main aspect of community pharmacists and their services was the ability to give advice more than sell medicine (28.48%). According to 3 domains: community pharmacist competency, community pharmacy service, and community pharmacy future service included a total of 43 statements of expectations. The domains’ highest scores were “demonstrate high professional and ethical practice” (4.83 ± 0.45), “do not sell expired and illegal drugs” (4.87 ± 0.47), and “able to refer patients needing intensive care to a hospital” (4.20 ± 0.86), respectively. In conclusion, community pharmacists were expected to be moral and ethical, provide good quality medicine, and facilitate customers’ ease of access to health services.
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Behaviors and Attitudes of Medication Label Writing According to The Good Pharmacy Practice of Northern Community Pharmacists
Article
Full-text available
  • Jul 2018
This research aimed to survey the completeness of information on medicine pouches, medication labelling behaviors and attitudes of community pharmacists in the northern of Thailand toward the information of drug labelling following the good pharmacy practice (GPP). The data were collected using a questionnaire sent by mail. The subjects were 279 community pharmacies (type I) located in 8 provinces of northern Thailand. Forty-nine questionnaires (17.6%) were analyzed. The study found that no drugstore showed complete information on the medicine pouches according to GPP. The most displayed information covered drug use directions (49, 100%); drug indications (46, 93.9%) and drug precautions (44, 89.9%). No respondent could write a complete medicine label. The information mostly written on drug label included drug use directions (37, 75.5%); drug indications (33, 67.3%) and the name, address and telephone number of the drug store (29, 59.2%). On the other hand, the respondents have not written the following information on the labels: pharmacist signature (38, 77.6%); patient’s name (30, 61.2%) and date of drug dispensing (23, 46.9%). A study of attitude of community pharmacists toward medicine labels found that the most important information consisted of drug use directions (4.92 ± 0.27), drug indications (4.80 ± 0.46) and drug precautions (4.57 ± 0.68). The respondents indicated that the less important information on drug pouches included pharmacists' signature (2.55 ± 1.14); the patients' name (2.82 ± 1.19), and the amount of drug dispensed (3.02 ± 1.18). It can be concluded that almost every drug stores failed to display complete important information, and the community pharmacists did not entirely label the medicine pouches according to GPP. The attitudes of community pharmacists towards the information on drug labels had low level in some areas.
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Patients'/Clients' Expectation Toward and Satisfaction from Pharmacy Services
Article
Full-text available
  • Jan 2017
Objective Satisfaction is becoming a popular health-care quality indicator as it reflects the reality of service or care provided. The aim of this study was to assess the level of patients' expectation toward and satisfaction from pharmacy service provided and to identify associated factor that might affect their expectation and satisfaction. Methods A cross-sectional study was conducted on 287 patients, who were served in five pharmacies of Gondar University Hospital in May 2015. Data regarding socio-demographic characteristics and parameters that measure patients' expectation and satisfaction were collected through interview using the Amharic version of the questionnaire. Data were entered into SPSS version 21, and descriptive statistics, cross-tabs, and binary logistic regressions were utilized. P < 0.05 was used to declare association. Findings Among 287 respondents involved in the study, 149 (51.9%) claimed to be satisfied with the pharmacy service and setting. Two hundred and twenty-nine (79.4%) respondents have high expectation toward gaining good services. Even though significant association was observed between the pharmacy type and patients level of satisfaction, sociodemographic characteristics of a patient were not found to predict the level of satisfaction. There is a higher level of expectation among study participants who earn higher income per month (>(2000 Ethiopian birr [ETB]) than those who get less income (<1000 ETB). Conclusion Although patients have a higher level of expectation toward pharmacy services, their satisfaction from the service was found to be low.
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Sampling: How to select participants in my research study?
Article
Full-text available
  • Jun 2016
Background:: In this paper, the basic elements related to the selection of participants for a health research are discussed. Sample representativeness, sample frame, types of sampling, as well as the impact that non-respondents may have on results of a study are described. The whole discussion is supported by practical examples to facilitate the reader's understanding. Objective:: To introduce readers to issues related to sampling.
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A literature review to explore the link between treatment satisfaction and adherence, compliance, and persistence
Article
Full-text available
  • Jan 2012
To explore the published evidence on the link between treatment satisfaction and patients' compliance, adherence, and/or persistence. Articles published from January 2005 to November 2010 assessing compliance, adherence, or persistence and treatment satisfaction were identified through literature searches in Medline, Embase, and PsycInfo. Abstracts were reviewed by two independent researchers who selected articles for inclusion. The main attributes of each study examining the link between satisfaction and adherence, compliance, or persistence were summarized. The database searches yielded 1278 references. Of the 281 abstracts that met the inclusion criteria, 20 articles were retained. In the articles, adherence and compliance were often used interchangeably and various methods were used to measure these concepts. All showed a positive association between treatment satisfaction and adherence, compliance, or persistence. Sixteen studies demonstrated a statistically significant link between satisfaction and compliance or persistence. Of these, ten demonstrated a significant link between satisfaction and compliance, two showed a significant link between satisfaction and persistence, and eight demonstrated a link between either a related aspect or a component of satisfaction (eg, treatment convenience) or adherence (eg, intention to persist). An equal number of studies aimed at explaining compliance or persistence according to treatment satisfaction (n = 8) and treatment satisfaction explained by compliance or persistence (n = 8). Four studies only reported correlation coefficients, with no hypothesis about the direction of the link. The methods used to evaluate the link were varied: two studies reported the link using descriptive statistics, such as percentages, and 18 used statistical tests, such as Spearman's correlation or logistic regressions. This review identified few studies that evaluate the statistical association between satisfaction and adherence, compliance, or persistence. The available data suggested that greater treatment satisfaction was associated with better compliance and improved persistence, and with lower regimen complexity or treatment burden.
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Situation and Readiness of Drug Store Entrepreneur on Ministerial Regulations for Permission and Pharmacy Licensing 2013 in Nakhon Pathom
Article
  • Oct 2016
Ministerial Regulations for Permission and Pharmacy Licensing is amended in 2013. The registered drug stores are needed to prepare followed the regulations by 2021. This study is aimed to analyze the situation and evaluate the readiness of drug store entrepreneurs in following the regulations 2013. Methods: The situation and readiness are categorized into five categories by the regulations: Category 1 place, Category 2 equipment, Category 3 practice of community pharmacy on staff, Category 4 practice of community pharmaqcy on medicine quality control and Category 5 practice of community pharmacy on pharmacy service. The study is divided into two parts: part1 survey the situation and the readiness by interview and part 2 focus group of pharmacy entrepreneurs to comment on the evaluation criteria of the regulations. Data was gathered from entrepreneur of 58 general drug stores and 12 accredited drug stores in Nakorn Pathom between April and May 2015. Results: the situation and the readiness of drug store entrepreneurs to comply with the regulations from low to high are Category 1, Category 2, Category 3, Category 5 and Category 4, respectively. Most of drug store entrepreneurs estimate budget for this investment around 10,000- 50,000 baht. The entrepreneurs mostly agree with the evaluation criteria of the regulations, except form and criteria of screening and referral patient. The reason of the exception is as unclear of the form and criteria. The unclear of evaluation criteria of the regulations are further found from focus group conversation such as method of continuing pharmaceutical education. Conclusion: Category 1, place, has the least readiness out of all 5 categories. Therefore, regulations and policy needs to be developed; and budget needs to alloted in order to help drug store entrepreneurs meet the criteria
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Framework for pharmacy services quality improvement – a bridge to cross the quality chasm. Part I. The opportunity and the tool
Article
  • Jan 2004
To review the literature on the subject of quality improvement principles and methods applied to pharmacy services and to describe a framework for current and future efforts in pharmacy services quality improvement and effective drug therapy management. The Academy of Managed Care Pharmacy produced the Catalog of Pharmacy Quality Indicators in 1997, followed by the Summary of National Pharmacy Quality Measures in February 1999. In April 2002, AMCP introduced Pharmacy's Framework for Drug Therapy Management in the 21st Century. The Framework documents include a self-assessment tool that details more than 250 specific "components" that describe tasks, behaviors, skills, functions, duties, and responsibilities that contribute to meeting customer expectations for effective drug therapy management. There are many opportunities for quality improvement in clinical, service, and cost outcomes related to drug therapy management. These may include patient safety; incidence of medical errors; adverse drug events; patient adherence to therapy; attainment of target goals of blood pressure, glucose, and lipid levels; risk reduction for adverse cardiac events and osteoporotic-related fractures; patient satisfaction; risk of hospitalization or mortality; and cost of care. Health care practitioners can measure improvements in health care quality in several ways including (a) a better patient outcome at the same cost, (b) the same patient outcome at lower cost, (c) a better patient outcome at lower cost, or (d) a significantly better patient outcome at moderately higher cost. Measurement makes effective management possible. A framework of component factors (e.g., tasks) is necessary to facilitate changes in the key processes and critical factors that will help individual practitioners and health care systems meet customer expectations in regard to drug therapy, thus improving these outcomes. Quality improvement in health care services in the United States will be made in incremental changes that rely on a structure-process-outcome model. The structure is provided by evidence created from controlled randomized trials and other studies of care and system outcomes that are based on the scientific method. The process portion is created by the application of evidence in the form of clinical practice guidelines, clinical practice models, and self-assessment tools such as Pharmacy's Framework for Drug Therapy Management. Incremental changes in structure and process will result in the desirable outcome of meeting customer needs for more effective drug therapy and disease management.
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Guideline to achieve mandatory GPP regulation. Nonthaburi: Food and Drug Administration
  • Jan 2015
  • S Vimolkittiphong
  • M Pantong
Vimolkittiphong S, Pantong M. Guideline to achieve mandatory GPP regulation. Nonthaburi: Food and Drug Administration; 2015.
Kanchanaburi Pharmacy develop ment for Good Pharmacy Practice (GPP) accomplish ment
  • Jan 2015
  • 27-34
  • W Weerapasuk
Weerapasuk W. Kanchanaburi Pharmacy develop ment for Good Pharmacy Practice (GPP) accomplish ment. FDA Journal 2015; 22: 27-34.
Inspection of the compliance to the Ministerial Rule on licensing and requirements on premises, instruments and good pharmacy practice among drugstores in Lamphun
  • Jan 2015
  • 95-104
  • I Intapun
Intapun I. Inspection of the compliance to the Ministerial Rule on licensing and requirements on premises, instruments and good pharmacy practice among drugstores in Lamphun. Thai Journal of Pharmacy Practice 2015; 7: 95-104.