1.1 Introduction
Use of drugs in developing countries has been described as ‘irrational’ by many authors; the prescribing and dispensing of ineffective, unsuitable, sub-optimal or unsafe pharmaceutical products has been widely documented (Smith, 2004 and Grand et al., 1999). A wide range of contributing factors include difficulties in ensuring the continuous availability of essential drugs, limited finance for health care and shortages of trained personnel. Other challenges include, lack of enforcement of regulations, high prevalence of counterfeit products, access to objective drug information, costs to individuals for purchasing drugs, and health beliefs and cultural traditions regarding their use. The weakness or the absence of national drug policies is also an important obstacle for implementing interventions to improve drug use.
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.
1.2 Background of Study
The World Health Organization (WHO) defines rational drug use as “patients receiving medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and the community” (WHO, 2002). Rational drug use also means using drugs which are safe and effective, given at adequate dose and for optimal duration of treatment (Grand et al., 1999). The Tanzanian ministry of health was one of the few ministries in the world that adapted the Essential Drugs Program (EDP) when it was introduced in early 1990’s by the WHO. This was to ensure that drugs are prescribed and dispensed rationally. Subsequently, rational drug use in Tanzania has been promoted by formulating the National Drug Policy (TMH, 1990).
Currently, there are about 700 pharmacists, 550 pharmaceutical technicians and 600 pharmaceutical assistants registered in Tanzania. There are more than 6,000 public and private pharmaceutical outlets countrywide (TFDA, 2004). This indicates a poor ratio between trained pharmaceutical personnel and pharmaceutical outlets. The government oversees running of the public health facilities such as hospitals, health centers and dispensaries. Usually, a pharmacy department in the hospital is operated under the supervision of pharmacists who are assisted by pharmaceutical technicians, pharmaceutical assistants and other drug dispensers.
However, drug policies can only be effective if mechanisms of implementation are in place, such as monitoring of national drug regulation, a good distribution system, regular supervision and adequate storage facilities. Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Knowledge, Attitude and Practices Regarding the use of Medicines Prescription.
1.3 Statement of Problems
Investigation reveals the challenges of allowing control of medicines by untrained dispensers promotes irrational dispensing and failure in the facilitation of patient’s adherence to treatment (Awad et al., 2007 and Waako et al., 2009). The major consequences of these effects are the emergence of multiple drug resistance, fatalities caused by toxicity, unforeseen drug’s adverse effects and interaction, treatment failures due to lack of patient adherence to treatment caused by improper information given to patients, and increased treatment costs to individuals and communities.
1.4 Aim and Objectives of Study
The aim of the study is to explore the Knowledge, Attitude and Practices Regarding the use of Medicines Prescription. In achieving this aim, the following specific objectives were laid out as follows:
- To measure the public knowledge and identify their attitudes and practices on medication use and safety
- To identify the difference in demographic characteristics between participants interviewed manually and electronically about medicines Prescription.
- To find out the difference in their level of knowledge, attitudes and practices related to medication use and safety.
- To identify predictors of the three studied domains (knowledge, attitudes and practices) among both studied samples.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What are the public knowledge and identify their attitudes and practices on medication use and safety?
- What is the difference in demographic characteristics between participants interviewed manually and electronically about medicines Prescription?
- What are the difference in their level of knowledge, attitudes and practices related to medication use and safety?
- What are the predictors of the three studied domains (knowledge, attitudes and practices) among both studied samples?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
- H0: There is no significant difference of the level of knowledge, attitudes and practices related to medication use and safety among participants
- H1: There is a significant difference of the level of knowledge, attitudes and practices related to medication use and safety among participants
1.7 Significance of Study
The study will be of great importance to researchers in the field of medical research on the use of medical prescription to reduce the prevalence of certain chronic diseases like HIV\\AIDS, Cancer and other bacterial infections. The result will also help in building up knowledge base on the care of the patients. Improving data base on patients’ health nutrition and standard of living which will help for further research, advocacy, policy dialogue and programming.
This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.
1.8 Scope of Study
The study focuses on the Knowledge, Attitude and Practices Regarding the use of Medicines Prescription in the urban area of Enugu State, Nigeria.
1.9 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Research material: availability of research material is a major setback to the scope of the study.
- Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
1.10 Definition of Terms
Health: Health is the level of functional and metabolic efficiency of a living organism. In humans it is the ability of individuals or communities to adapt and self-manage when facing physical, mental, psychological and social changes with environment.
Status: Status is a state, condition, or situation.