Medicines information services in a resource-limited setting

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Abstract

Introduction

In resource-limited settings, it is particularly important to explore the priorities for, as well as barriers to, development of health services. There has been limited development of medicines information (MI) services in Vietnam despite national guidelines.

Objectives

To explore the current status of MI services for healthcare professionals and patients in Vietnamese hospitals.

Methods

In 2018, all hospitals which were under the direct administration of the Ministry of Health and all 63 Provincial Health Bureaus were invited to participate (n = 1359). All national, provincial and district hospitals, as well as private hospitals and hospitals from other Ministries in Vietnam, were included. An online questionnaire about MI facilities, workforce, and activities was used.

Results

There were 560 eligible responses from pharmacists in hospitals. The most common MI service was pharmacovigilance (provided in 91% of hospitals), and the least common was providing MI for clinical case management (30%), nurse training (31%), and MI provision to patients (27%). Multivariate logistic regression analysis showed that the number of pharmacists and the geographical-economical area where hospitals were based had the strongest impact on the likelihood of offering more MI services in hospitals. While the type of hospital (traditional medicine vs. other hospitals) had some impact, hospital size, level, and specialization of hospital (general vs. specialized) did not have a significant impact on the provision of MI services.

Conclusion

The differences in workforce and location may contribute to differences in MI practices between hospitals. These findings are relevant for the implementation of a national MI strategy in Vietnam and other developing countries.

Section snippets

Background

Medicines information (MI) (also referred to as Drug information (DI)) provision to health care professionals (HCPs) and patients is one of the key activities of pharmacists.1,2 Pharmacists can serve as an accurate and reliable information source to ensure the quality use of medicines.3 MI provision involves several consecutive steps, which include receiving a request for MI, finding, evaluating, synthesizing information before delivering, and documenting the answers to the clients who are HCPs

Aims

This study aimed to: (1) investigate the workforce involved in providing clinical pharmacy and MI activities; (2) describe the current types of MI activities undertaken; and (3) explore the extent and documentation activities of MI services for HCPs and outpatients in Vietnamese hospitals.

Settings

In 2015, there were a total of 13,508 hospitals and health facilities in Vietnam. Most (93.1%) were directly under the administration of the Ministry of Health (MOH) and 63 Provincial Health Bureaus in 63 provincials. The others (6.9%) were under the administration of other ministries (5.6%), such as the Ministry of Defense, or private hospitals (1.4%).16

In Vietnam, health facilities have been classified by the MOH as the national, provincial, district, and communal levels according to their

Results

A total of 621 responses from a total of 1359 hospitals were received. Responses from 6 commune centers without beds, and two control and prevention centers which did not have pharmacy departments were removed, together with 53 duplicate responses, leaving 560 eligible responses from 560 hospitals (response rate of 41.2%). The response rate was highest for national hospitals (Table 1), and private hospitals had the lowest response rate.

There were opposing trends regarding pharmacist workforce

Discussion

To our knowledge, this was the first time there was a study investigating the pharmacist-led medicine information (MI) services in hospitals in a developing country. Previous studies have mostly focused on process indicators of MI centers (MICs) such as studies in Ethiopia,28 Uganda,23 India,24,29,30 Sudan,31 Zimbabwe,19 and Estonia.32 This study provides data on the range of MI activities offered, which may serve as a benchmark for other low-income and developing countries.

To the best of our

Conclusion

This study showed that pharmacovigilance and MI provision via paper were the most common activities and services provided while MI for patients was the least common in Vietnamese hospitals. The differences in the number of pharmacists per hospital bed, as well as the hospital level, could impact the MI practices reported. These findings could inform the implementation of MI policies in developing countries.

CRediT authorship contribution statement

Trung Hieu Trinh: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Visualization, Writing - original draft. Jo-anne Brien: Conceptualization, Methodology, Visualization, Writing - review & editing, Supervision, Project administration. Huong Nguyen: Conceptualization, Methodology, Investigation, Writing - review & editing. Ha Ngo: Investigation, Resources, Writing - review & editing. Thao Le: Investigation, Resources, Writing - review & editing. Hoa Vu: Methodology,

Acknowledgements

The authors would like to thank the hospital pharmacists for their participation in this study. We also thank the staff in the MOH for their support in data collection.

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