Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 19085

AbstractMaterial and MethodsResultsDiscussionConclusionReferences
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2009 | Month : April | Volume : 3 | Issue : 2 | Page : 1408 - 1413 Full Version

Perception Of Nepalese Community Pharmacists Towards Patient Counseling And Continuing Pharmacy Education Program: A Multicentric Study


Published: April 1, 2009 | DOI: https://doi.org/10.7860/JCDR/2009/.465
POUDEL A*,KHANAL S**,ALAM KADIR***, PALAIAN S****

*B.Pharm, Hospital and Clinical Pharmacist, **B.Pharm, Hospital and Clinical Pharmacist, ***M.Pharm, Lecturer, ***M.Pharma, Asst. Prof, Dept. of Hospital and Clinical Pharmacy, Manipal College of Medical Sciences.

Correspondence Address :
Arjun Poudel (B.Pharma), Hospital and Clinical Pharmacist Drug Information and Pharmacovigilance Center, Dept. of Hospital and Clinical Pharmacy Manipal Teaching Hospital, Pokhara, Nepal.E.mail:poudelarjaan@gmail.com,P:+977 61 526420,Mobile:+977 98460 33006

Abstract

Objective: To study the perception of community pharmacists towards patient counseling and continuing pharmacy education programs.
Methods: A semi structured questionnaire was developed by the researchers. The research was carried out in six major cities in Nepal, namely Kathmandu, Pokhara, Biratanagar, Birgunj, Nepalgunj and Bhairahawa. The filled questionnaires were analyzed as per the study objectives.
Results: Altogether, 60 community pharmacists were included. Among them, 88.33% (n=53) were male. More than 50 patients visit most of the community pharmacies [36.67% (n=22)] daily. Most of the dispensers [56.67% (n=34)] took 1-5 minutes for dispensing a prescription. In most of the pharmacies [56.67% (n=34)], there were 2-5 dispensers and the qualification of a majority of dispensers were orientation training. Most of them [56.67% (n=340] believed that counseling was necessary as it was their own duty, but however, 48.33% (n=29) said that it was necessary to increase patient compliance. Our finding suggests that 83.33% (n=50) of retailers were facing some problems during patient counseling. All participants were interested in the continuing pharmacy education program.
Conclusion: On the whole, the community pharmacists had a positive response towards patient counseling. Our findings suggest the need for continuing pharmacy education programs in Nepal to strengthen the concept of patient counseling.

Keywords

Community pharmacy,Community pharmacist,Patient counseling,Continuing pharmacy education,Nepal

Introduction
Across the world, every day, millions of people visit community pharmacies for their health care needs(1). Pharmacists are placed at the first point of contact in the health care system due to their free accessibility and friendly approach. In contrary to this scenario, many general practitioners do not regard pharmacists as potential members of the health care team(1). In recent times, much focus was laid on the new roles of the community pharmacists in developed countries like Australia, United States of America and the United Kingdom. The role of the pharmacist, especially as a health adviser, is highly esteemed and acknowledged by general practitioners in these countries(1).

The need and potential for counseling the patients regarding their drug therapy has been an important part of the pharmacy practice and pharmaceutical care. It has been the responsibility of the pharmacist to counsel the patients before dispensing the medication(2). Counseling not only enhances compliance, but also reduces complications due to non-compliance to treatment(3). Pharmacists are trying to move away from a drug-focused approach to a patient oriented approach according to the patient’s needs, with the aim of achieving better outcomes from drug therapies(4). This requires close co-operation between pharmacists and other health care professionals, especially physicians, and requires knowledge and skills extending beyond the product knowledge about medicines(5).

Despite the beneficial role of community pharmacists, not much research focusing on their roles and responsibilities have been conducted in developing countries like Nepal. According to a study conducted in Nepal, self medication and non-doctor prescription were the common drug use problems there (6). In the same scenario, people without academic qualifications in field of pharmacy were allowed to run pharmacies and dispense medicines in Nepal (7). A study conducted in the capital city of Nepal demonstrated that unauthorized dispensing is clearly problematic, although the legislation in Nepal approves a medical prescription for the purchase of antibiotics(8). Drug retailers do not have adequate understanding about the disease process in question, in order to justify their sale of those antibiotics. More exhaustive efforts to educate drug retailers on their role in dispensing, along with increased enforcement of existing regulations, must be followed in Nepal (8). Therefore, there is a greater need to advocate and conduct research concerning long term health promotion and public education through the profession of pharmacy (9). In order to improve the professional roles of pharmacists in Nepal, there is a need for training the community pharmacists towards patient counseling. Evaluating the current perception of the community pharmacists can be useful to initiate appropriate interventions. Hence, the present study was undertaken with the following objectives.

Objectives
The objectives of the study were
1. To study the demographic details of the community pharmacists
2. To study the sources of drug information used by the community pharmacists
3. To explore the community pharmacist’s perceptions towards patient counseling and to identify the major barriers for effective counseling
4. To evaluate the community pharmacist’s perception towards continuing pharmacy education programs.

Material and Methods

Questionnaire
A semi-structured questionnaire was formulated by the researchers (Appendix-1) (Table/Fig 1) as per the study objectives.

Data Collection
A prospective study was conducted between 15th January 2008 to 15th March 2008 (two months) in six major cities of Nepal (Biratanagar from the eastern region, Birgunj and Kathmandu from the central region, Bhairahawa and Pokhara from the western region and Nepalgunj from the mid-western region of Nepal). 10 randomly selected community pharmacies from each city were included in the study. Community pharmacists from the randomly selected pharmacies were interviewed with the formulated questionnaire.

Data Analysis
The filled questionnaires were analyzed as per the study objectives using Microsoft Excel version 2003. The SPSS version 9.0 was used to carry out the descriptive statistics.

Results

Altogether, 60 community pharmacists were included in this study. Among them, 88.33% (n=53) were males and 11.66% (n=7) were females.

Number of patients visiting community pharmacies (n=60)
Everyday, more than 50 patients visited 36.6% (n=22) of the community pharmacies, followed by 35-50 patients [26.6% (n=16)], 20-25 patients [20% (n=12)] and 10 -20 patients [16.6% (n=10)] to fill their prescriptions.

Dispensing time in community pharmacies (n=60)
More than half [56.6% (n=34)] of the dispensers took 1-5 minutes for dispensing a prescription, followed by 5-10 minutes [31.6% (n=19)]. Ten percentage (n=6) of them took more than 10 minutes, and 1% of them took less than 1 minute. In most of the pharmacies [56.67% (n=32)], there were 2-5 dispensers, followed by a single pharmacist in 33.33% (n=20) of pharmacies and only 13.33% (n=8) of pharmacies had more than 5 dispensers.

Qualification of the owners of community pharmacies (n=60)
The qualifications of the owners of the pharmacy were orientation training [83.33% (n=50)], followed by D. Pharm [8.33% (n=5)], B.Pharm [3.33% (n=2)] and other qualifications [5% (n=3)].

Problem faced during patient counseling (n=77)
Fifty four percent (n=41) of community pharmacists felt that lack of time was the major problem or barrier faced during patient counseling, followed by lack of knowledge 28% (n=21), and lack of patient interest 8% (n=6). Eight percentage (n=6) of them felt that they do not face any problems during patient counseling. Four percentage (n=3) had other problems.

Strategies suggested by dispensers to overcome the barriers (n=90)
The various strategies suggested by the dispenser to overcome the experienced barriers, are given in (Table/Fig 3).


Qualification of dispensers of community pharmacies (n=118)
As like the qualification of owners of the pharmacies, the qualifications of a majority of dispensers were orientation training [61% (n=72)] followed by other qualifications [30% (n=35)]. Six percentage (n=7) of the dispensers were D. Pharm holders and only 3% (n=4) had a B. Pharm degree.

Common sources of drug information available in the community pharmacies (n=108)
The commonest sources of drug information were, the Current Index of Medical Specialties (CIMS), a commonly used drug index from the neighboring country India [52% (n=56)], followed by Indian Drug Review [(IDR) 8.33% (n=9)] and Monthly Index of Medical Specialties (MIMS) [6.48% (n=7)].

The purpose of giving medication counseling (n=110)
There are different feelings among the dispensers regarding the counseling. Nearly one third [31% (n=34)] of them considered counseling as their duty. The views expressed by them regarding the purpose of counseling are given in (Table/Fig 2).

Frequently asked questions by the patients (n=210)
Patients asked several questions to the pharmacists while counseling. The details on frequently asked questions are given in (Table/Fig 4).

The dispenser’s interest in the CPE program (n=116)
All the participants (community pharmacists or respondents) were interested in the Continuing pharmacy education (CPE) program and all of them felt that Continuing pharmacy education program would help in improving their knowledge. Furthermore, more number of dispensers were interested in the CPE program on common drugs [46% (n=53), followed by the CPE program on diseases [35% (n=41)], the CPE program on lifestyle [13% (n=15)] and others [6% (n=7)].




Discussion

Surveys have found that community pharmacies are very often the first and only source of health care outside the home. In Nepal, the Department of Drug Administration (DDA), the national drug controlling authority under the Ministry of Health and Population in the year 1981, established a 45-hr course for drug retailers, which emphasized practical training as well as formal teaching on pharmacology, ethics, storage of drugs, and legal issues(10). For running a community pharmacy, the DDA has allowed pharmacists, assistant pharmacists or persons who had taken a 45- hr course or training, as capable for running a pharmacy (11). In our study, the qualifications of the majority [61% (n=72)] of dispensers and pharmacy owners were found to be orientation training,. The reason might be the less number of pharmacists and assistant pharmacists available in the country(12). Several studies have suggested that private drug sellers generally have little formal education or professional training (13), (14).

Our study found that on an average 50 patients visit most of the community pharmacies per day. Most of the dispensers took 1-5 minutes for dispensing a prescription. The drug utilization study in Nepal has suggested that the average dispensing time in the public sector is 86.1 seconds (15).

The major source of drug information available at community pharmacies was the Current Index of Medical Specialties (CIMS) [52% (n=56)]. Use of the British National Formulary (BNF) and the American Hospital Formulary Service (AHFS), were also found in some of the pharmacies. Most of dispensers in this study feel that providing counseling to the patient is the duty of the pharmacist. Many professional organizations like the Society of Hospital Pharmacists Australia (SHPA) and The American Society of Health-System Pharmacists (ASHP), have also mentioned that patient counseling is the responsibility of pharmacists (16),(17) The concept of patient counseling by pharmacists is new in Nepal. However, the Manipal Teaching Hospital (MTH) in Western Nepal had established a counseling center during the beginning of March 2004. The preliminary evaluation of the services provided by the center concluded that the medication counseling center can play a definite role in enhancing the patient’s understanding about medications and the disease pattern, which in turn may improve patient compliance (18). Moreover, the newly drafted National Good Pharmacy Practice Guidelines also suggest that the pharmacist should provide counseling (19).

Lack of time was the major problem faced by the most of the dispensers, which was mainly due to the lack of manpower. However, a study conducted by Mishra et al. found language to be the major barrier for better counseling (18). As lack of time was the major problem faced by a majority of dispensers the solution suggested by them to overcome the barriers, was to increase the number of pharmacists. According to the dispensers, frequently asked questions by the patients were related to costs, doses and duration of the medication. The query related to cost was the most expected one, as the per capita income of the Nepalese population is very less. Similarly, the query related to dose and duration of the medication was also common, because it was always confusing when more than one drug was prescribed.

All participants were interested in the Continuing pharmacy education (CPE) program and felt that the Continuing pharmacy education program would help in improving their knowledge. One of the studies on the effect of a continuous community pharmacy practice also suggested that the program was beneficial for all students and participating pharmacists (20). Community pharmacists participated in patient counseling more frequently than institutional pharmacists, while institutional pharmacists participated in drug monitoring more frequently than community pharmacists. Community pharmacists had more direct access to patients and so the counseling was effective (21).

Conclusion

Our study found that community pharmacists in Nepal meet a larger number of patients and are interested in patient counseling. Their education level is low and thus, there is a need for CPE programs for them in order to upgrade their knowledge. They are at present, equipped with a limited number of drug information sources needed to provide patient counseling. There is a need for research in this area, involving more number of community pharmacists, so as to extrapolate our findings.

Limitations
Though the study was successful in evaluating the perception of the Nepalese community pharmacists on patient counseling and CPE programs, it had a few limitations. The total numbers of pharmacists studied were low and hence, our findings may not reflect the perception of the entire community of pharmacists in Nepal.

References

1.
. Adepu R and Nagavi BG. General practitioners’ perception about the extended roles of community pharmacists in the state of Karnataka: A study. Indian J. Pharm. Sci. 2006; 68: 36-40.
2.
. Popovich NG. Ambulatory patient care. In: Gennaro AR editor Remington: The science and practice of pharmacy, Vol.2. Mack Publishing Company, Pensylvania, 19th Ed, 1995; 1695-1719.
3.
. Palaian S, Prabhu M, Shankar PR. Patient counseling by pharmacists: a focus on chronic illness. Pak J Pharm Sci. 2006; 19: 65-72.
4.
. De Young M. Reflections on guidelines and theories for pharmacist-patient interactions. J Pharm Teaching 1996; 5:59-81.
5.
. Kansanaho H, Pietila K and Airaksinen M. Can a long-term continuing education course in patient counseling promote a change in the practice of Finnish community pharmacists? Int J Pharm Pract 2003; 11:153–60.
6.
. Shankar PR, Partha P and Shenoy N. Self-medication and non-doctor prescription practices in Pokhara valley, Western Nepal: a questionnaire-based study BMC Fam Pract 2002; 3: 1-7.
7.
. Drug Act of Nepal. Available online on http://www.dda.gov.np/drugact.php 1978. (Accessed on May 19, 2008).
8.
. Wachter DA, Joshi MP, Rimal B. Antibiotic dispensing by drug retailers in Kathmandu, Nepal. Trop Med Int Health. 1999; 4: 782-8.
9.
. Hanan B, Sokar-todd B and Einarson TR. Community pharmacy practice research: a systematic review of the past 32 years. Canadian Pharm. J. 2003; 136: 26- 38.
10.
. Kafle KK et al. Drug retailer training: experiences from Nepal. Soc Sci Med. 1992; 35: 1015-25.
11.
. Department of Drug Administration 1979 (DDA). New pharmacy registration. Availableon http://www.dda.gov.np/pharmacy%20_registration/karyabidhipasal2063R.pdf (accessed on June 14, 2008).
12.
. Nepal Pharmacy Council (NPC). Pharmacist registered with Nepal Pharmacy Council. NPC News Letter 2007; 2; 6-8.
13.
. Ferguson AE. Commercial pharmaceutical medicine and medicalization a case study from El Salvador in Cult. Med. Psychiat. 1981; 5; 105-34.
14.
. Wolffers I. Drug information and sales practices in some pharmacies of Colombo, Sri Lanka. Soc Sci Med 1987; 25: 319-21.
15.
. Kafle KK. INRUD drug use indicators in Nepal: practice patterns in health posts in four districts. INRUD news 1992; 3: 15.
16.
. Dooley M, Lyall H, Galbraith K et al (1996). SHPA Standards of practice for Clinical Pharmacy. In SHPA practice standards and definitions: 2-11
17.
. ASHP guidelines on pharmacist-conducted patient education and counseling. Am J Health-Sys Pharm 1997; 54: 431-34
18.
. Mishra P, Subish P, Upadhyay DK, Bista S, et al. Medication counseling center in a teaching hospital. J Nepal Med Assoc 2005; 44: 129-34.
19.
. Good Pharmacy Practice Guidelines (GPP) (November 2005 draft). Developed by NepalPharmacy Council, Kathmandu, Nepal, Available online on http://www.dda.gov.np/guidlines/national_gpp.pdf (Accessed on May 19, 2008).
20.
. Thomas SG, Beck DE and Janer A. Effect of a continuous community pharmacy practice experience on student attitudes, motivation, and communication skills. Am J Pharm Educ 1997; 61: 125-31.
21.
. Schommer JC and. Cable GL. Current status of pharmaceutical care practice: strategies for education. Am J Pharm Educ 1996; 60: 36-42.

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com