OBJECTIVE
ORGANIZATION AND KEY COMPONENTS OF SESSION Materials For this session review the session notes, the overheads and the activity. If you want to do a role play of dispensing during the dispensing process sequence obtain drugs to be dispensed and labeling and packaging materials and prepare an assistant to play the dispenser role. Time: 3 hours This is flexible time and depends on whether a role-play is used and on the time spent on the activity. This is a suitable session for an afternoon session. Deciding when to do the activity depends on how the session is going. It can be done early after the "Who is a dispenser?" sequence or probably better after the dispensing "Practices to Enhance rational drug use" and before the break. PURPOSE The main purpose of the session is to recognize that many people dispense and that it is possible to improve the quality of dispensing through training and supervision. In most sessions there are a mixture of doctors and nurses and pharmacists or technicians. Often the doctors or nurses think they know what is required in dispensing but they usually have not had any training and often in fact dispense very badly. Pharmacists and pharmacy technicians have been taught to dispense and often assume that other health workers have also been trained. So they may be surprised at the ignorance of their fellow professionals. NOTES When discussing the case report say that this is a true report and that the pharmacist responsible was sent to jail for 6 months! Emphasize that dispensing is the final stage of the therapeutic process and that the success of the curative process depends on quality dispensing. Before showing VA4 "Who are Dispensers?" use a flip chart or blackboard to brainstorm suggestions from the class. Discuss the transparency What does a dispenser need? Pointing out pharmacy that these are universal requirements try to briefly describe the situation in different countries. When going through the steps of the dispensing process you may want to use a role play to focus attention on the different steps. Take each step, demonstrate it and then discuss possible problems that might occur at each stage. Participant involvement is easy to elicit with the question "What could go wrong at this stage?"
For the VA Potential Errors or Problems try to elicit additional ones that may have been missed. Point out the key point that dispensing takes time! Discuss the findings from the previous field activities related to the dispensing indicators. When going over the dispensing conditions questions point out that these questions could be used to check on dispensing areas in hospitals or pharmacies. IT IS A GOOD IDEA TO TAKE A BREAK BEFORE DISCUSSING THE ROLE OF PRESCRIBERS AND DISPENSERS IN PROMOTING CORRECT PRESCRIBING This discussion should be carefully handled to avoid doctors or pharmacists accusing each other’s profession of shortcomings. Insist on positive suggestions as to how things could be improved. There may be considerable discussion about the pharmacists role in research and in consumer education. When discussing methods to improve compliance try to identify what would need to be done and what the barriers are to doing this. The Public private question needs discussion in this session. Virtually all countries have private sector dispensers and how they relate to the public sector may be complex. The key point to be made is that addressing public sector dispensing alone may neglect most dispensing and that ways have to be found to involve the private sector. The interventions should all be discussed briefly and participants encouraged to view the posters on the CD-ROM. The message of these posters is that all except the Zimbabwe study which was not an intervention, show that changing dispensing practices are possible and are usually effective. The conclusion needs to be reinforced at the end of the session. Slide 1
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