You are here

American Journal of Public Health Research

ISSN (Print): 2327-669X

ISSN (Online): 2327-6703

Editor-in-Chief: Jing Sun

Website: http://www.sciepub.com/journal/AJPHR

   

Article

Pharmaceutical Representatives' Opinion about Pharmacists' Drug Dispensing Practices in Romania and Factors that Influence them

1Behavioral Sciences, Department of Preventive Medicine and Interdisciplinarity, University of Medicine and Pharmacy “Gr.T.Popa” Iasi, Romania


American Journal of Public Health Research. 2016, 4(3), 88-92
doi: 10.12691/ajphr-4-3-2
Copyright © 2016 Science and Education Publishing

Cite this paper:
Laszlo-Zoltan Sztankovszky, Magdalena Iorga, Vasile Astaratoae. Pharmaceutical Representatives' Opinion about Pharmacists' Drug Dispensing Practices in Romania and Factors that Influence them. American Journal of Public Health Research. 2016; 4(3):88-92. doi: 10.12691/ajphr-4-3-2.

Correspondence to: Magdalena  Iorga, Behavioral Sciences, Department of Preventive Medicine and Interdisciplinarity, University of Medicine and Pharmacy “Gr.T.Popa” Iasi, Romania. Email: magdaiorga@yahoo.com

Abstract

The objective of the research is to identify pharmaceutical representatives’ opinions on some practices of drug dispensing amongst community pharmacists in Romania. Material and methods: 70 pharmaceutical representatives working with different pharmaceutical companies in Romania answered questions regarding practices of drug dispensing. Different variables were taken into account: age, gender, type of education, and length of employment time. Collected data were analyzed with SPSS 17.0. Results: over 70% of the pharmaceutical representatives consider that pharmacists counsel the patient regarding other drug brand names and take into consideration patient financial contribution when dispensing a certain drug. Regarding the relationship of the pharmacist with doctor and rep, 65% of pharmaceutical representatives consider the relationship with the doctor, and 40% the relationship with the rep, important when dispensing a drug. No important differences were identified in relation to the gender or type of education. Conclusion: the study provides information regarding pharmaceutical representatives’ opinions on practices of drug dispensing. More than 2/3 of the reps consider that pharmacists are counseling the patient regarding a drug to a high level.

Keywords

References

[1]  Hirsh, H., Coen, M.H., Mozer, M.C., Hasha, R. and Flanagan, J.L, “Room service, AI-style,” IEEE intelligent systems, 14 (2). 8-19. Jul.2002.
 
[2]  Barcaccia, B., Esposito, G., Matarese, M., Bertolaso, M., Elvira, M., De Marinis, M. G. “Defining quality of life: a wild-goose chase?” Europe’s Journal of Psychology, 9(1). 185-203. 2013.
 
[3]  Bielderman, A., de Greef, M. H. G., Krijnen, W. P., van der Schans, C. P. “Relationship between socioeconomic status and quality of life in older adults: a path analysis,”Quality of Life Research, 1-9. 2014.
 
[4]  Avorn, J. Solomon, D. H. “Cultural and economic factors that (mis) shape antibiotic use: the nonpharmacologic basis of therapeutics,” Annals of Internal Medicine, 133(2). 128-135. 2000.
 
[5]  McKinlay, J. B., Trachtenberg, F., Marceau, L. D., Katz, J. N., Fischer, M. A. “Effects of patient medication requests on physician prescribing behavior: results of a factorial experiment,” Medical care, 52(4). 294-299. 2014.
 
Show More References
[6]  Ostini, R., Hegney, D., Jackson, C. &Tett, S. E. “Knowing how to stop: ceasing prescribing when the medicine is no longer required,” J Manag Care Pharm, 18(1). 68-72. 2012.
 
[7]  Kaiser, B., Schmid, C. “Does physician dispensing increase drug expenditures? Empirical evidence from Switzerland. Health economics,” 2014.
 
[8]  Fox, N. J., Ward, K. J., O’Rourke, A. J. “The ‘expert patient’: empowerment or medical dominance? The case of weight loss, pharmaceutical drugs and the Internet,” Social Science & Medicine, 60(6). 1299-1309. 2005.
 
[9]  Lorig, K. “Partnerships between expert patients and physicians,” The Lancet, 359(9309). 814-815. 2002.
 
[10]  Shaw, J, Baker, M. “Expert patient — dream or nightmare? The concept of a well informed patient is welcome, but a new name is needed,” BMJ: British Medical Journal, 328(7442). 723-724. 2004.
 
[11]  Kisa, A. The Performance and Problems of the Turkish Pharmaceutical Industry: Is there a need to develop a national drug policy? Journal of medical system 2001; 25:5:309-318.
 
[12]  Wang, D., Thumula, V., Liu, T. C. “”Are physician dispensing reforms sustainable?” http://www.wial.com/documents/2015/04/wcri-paper-2.pdf Retrieved at 10 June 2015.
 
[13]  Hussain, A., & Ibrahim, M. I. M. “Medication counselling and dispensing practices at community pharmacies: A comparative cross sectional study from Pakistan,” International journal of clinical pharmacy, 33(5). 859-867. 2011.
 
[14]  Dueñas, G. G., Pringle, J. L. Physician perceptions of pharmacist-provided medication therapy management: qualitative analysis. Journal of American Pharmacists Association 2010; 50:67-71.
 
[15]  Muijrers, P. E., Grol, R. P., Sijbrandij, J., Janknegt, R. &Knottnerus, J. A. Differences in prescribing between GPs. Impact of the cooperation with pharmacists and impact of visits from pharmaceutical industry representatives. Family Practice 2005; 22:6:624-630.
 
[16]  Rosenthal, M. B., Berndt, E. R., Donohue, J. M., Frank, R. G., Epstein, A. M. “Promotion of prescription drugs to consumers,” New England Journal of Medicine, 346(7). 498-505. 2002.
 
[17]  Sztankovszky, L.Z., Soponaru, C., Iorga, M., Astarastoae, V. “Pharmacists' and doctors’ perception of pharmaceutical representative’s ethical practices of drug promotion in Romania. A comparative study,” Postmodern Openings; 6(1). 189-199. 2015.
 
[18]  Beatty, S. J., McCormick, K. M., Beale, D. J., Bruggeman, A. M., Rodis, J. L., Mehta, B. H., Bennett, M. S. “Current trends in outpatient pharmacy services and billing,” Journal of the American Pharmacists Association,52(2). 154-160. 2012.
 
[19]  Doucette, W. R., McDonough, R. P., Mormann, M. M., Vaschevici, R., Urmie, J. M., Patterson, B. J. “Three-year financial analysis of pharmacy services at an independent community pharmacy,” Journal of the American Pharmacists Association, 52(2). 181-187. 2012.
 
[20]  Lopez-Trigo, P., Khanfar, N. M., Alameddine, S., Harrington, C. “Banning Tobacco Sales at the Retail Pharmacy: Natural Evolution of Drug Store as Responsible Health Provider Or Effective Marketing Strategy?” Health marketing quarterly, 382-393. 2015.
 
[21]  Harding, G., Taylor, K. M. G. “Pharmacy's strength lies in its blend of clinical, scientific and social skills,” Pharmaceutical Journal, 273. 126. 2004.
 
[22]  Iorga, M., Sztankovszky, L.Z., Soponaru, C., Gardikiotis, I. “Pharmacists’s attitudes and practices regarding drug dispensing in Romania,” Revista Farmacia, 63(4). 601-606. 2015.
 
[23]  Sztankovszky, L. Z., Iorga, M., Diaconescu, S., Astarastoae, V. “Is the Family Doctors' drug Prescribing Behavior Influenced by the Relationship with Pharmacists and Pharmaceutical Representatives?”, Social Research Reports, 27. 88-95. 2015.
 
Show Less References

Article

Does Breast Cancer Risk Awareness Motivate Personal Prevention Practices: Findings from a Community-based Assessment?

1University of Kabianga, Kabianga, Kenya

2Tropical Institute of Community Health, Great Lakes University of Kisumu, Kisumu, Kenya

3School of Public Health, Capital Medical University, Beijing, China

4School of Health Science, Great Lakes University of Kisumu, Kisumu, Kenya


American Journal of Public Health Research. 2016, 4(3), 93-97
doi: 10.12691/ajphr-4-3-3
Copyright © 2016 Science and Education Publishing

Cite this paper:
Ouma J, Olang’ S, Asweto CO, Obago IT, Kaseje D. Does Breast Cancer Risk Awareness Motivate Personal Prevention Practices: Findings from a Community-based Assessment?. American Journal of Public Health Research. 2016; 4(3):93-97. doi: 10.12691/ajphr-4-3-3.

Correspondence to: Ouma  J, University of Kabianga, Kabianga, Kenya. Email: j.ouma@kabianga.ac.ke

Abstract

Breast cancer, is the leading cause of cancer specific mortality. But nearly 80% of the mortality is preventable by early diagnosis. We assessed knowledge and practice of breast cancer prevention by women in a rural community setting. Data was collected on demographics, family history, knowledge and practice of breast cancer by interviewer administered questionnaire. Knowledge (including knowledge of risk) and practice were measured using a response-based score to a set of 9 and 10 questions respectively. Prevalence odds ratio was calculated to estimate association between independent and outcome variables. Knowledge of breast cancer risk was low (14.2%). Family history and socioeconomic status were significantly associated with knowledge; respondents with more than eight years of school were more likely to have higher knowledge (OR=2.859; CI=1.578-5.178). Practice of prevention was equally low (17.2%). Practice was significantly associated with knowledge; respondents with higher knowledge of prevention were more likely to practice prevention (OR=6.8; CI=3.308-14.104). We propose that community-based risk communication and awareness creating programs may motivate breast cancer prevention practices. Women of lower socio-economic status should especially be targeted with such interventions. There is need to develop these into a sustainable community-based health education program.

Keywords

References

[1]  WHO. (2008). World Cancer Report . Geneva: WHO Press.
 
[2]  Zimmerman J. (1997). The Belmonte Report: An Ethical Framework for Protecting Research Subject. Association of Clinical Research Professionals, Newton, USA. Available at http://www.impactcg.com/docs/BelmontReport.pdf.
 
[3]  Ekanem, A. (2009). History of Cancer Registration in the World and in Naigeria. Calabar: Calabar Cancer Registry.
 
[4]  WHO. (2007). The World Health Organisation's Fight Against Cancer; Strategies that prevent, cure and care. Geneva: WHO Press.
 
[5]  Akarolo-Antony, N., et al. (2010). Emerging Breast Cancer Epidemic: Evidence from Africa. Breast Cancer Research , 12 (4), 8.
 
Show More References
[6]  Howel, A. (2010). The Breast Cancer Epidemic; Early diagnosis and treatment. Breast Cancer Research , 12 (4), 10.
 
[7]  Uganda Breast Cancer Working Group (2003 Apr.). Breast cancer guidelines for Uganda. Afr Health Sci.; 3(1):47-50.
 
[8]  Newman LA, Fregene A. (2005). Breast cancer in sub-Saharan Africa: How does it relate to breast cancer in African-American women? International Journal of Cancer (103)8:1540-1550.
 
[9]  Chen VW, Correa P, Kurman PJ, et al. (1994). Histiologic characteristics of Breast Carcinoma in blacks and whites. Cancer epidemiology, Biomarkers & Prevention. 3:127-135.
 
[10]  Hakama M, Pukkala E, Kallio M, Godenhjelm K, Svinhufvud U (1995). Effectiveness of screening for breast cancer in women under 50 years at entry: The Kokta Pilot Project in Finland. International Journal of Cancer, 63:55-57. PubMed Abstract | Publisher Full Text
 
[11]  Semiglazov VF, Moiseenko VM, Manikhas AG, Protsenko SA, Kharikova RS, Popova RT, Migmanova NSh, Orlov AA, Barash NIu, Ivanova OA, Ivanov VG (1999). Role of breast self examination in early detection of breast cancer:Russia/WHO Prospective Randomize Trial In St. Petersburg. Cancer Strategy, 29:145-151.
 
[12]  Budden L (1995): Young women's breast self-examination knowledge and practice. Journal of Community Health Nursing, 12:23-32. PubMed Abstract | Publisher Full Text.
 
[13]  WHO and International Agency for Research on Cancer (2008). GLOBOCAN 2008. Estimated cancer Incidence, Mortality, Prevalence and Disability-adjusted life years (DALYs) Worldwide in 2008.< http://globocan.iarc.fr/.
 
[14]  Ministry of Public Health and Sanitation and Ministry of Medical Services (Ministries of Health). National Cancer Control Strategy. 2011-2016 http://www.ipcrc.net/pdfs/Kenya-National-Cancer-Control-strategy.pdf > Accessed 3 June 2013.
 
[15]  World Health Organization (2013). Fact sheet N°297 Reviewed January 2013 ttp://www.who.int/mediacentre/factsheets/fs29
 
[16]  Balagun, M., & Waoje, T. (2005). Knowledge and Practice of Breast Self Examination among Female Traders in Ibadan, Nigeria. Annals of Ibadan Postgraduate Medicine , 3 (2), 52-56.
 
[17]  Heidari, Z., et al. (2008). Breast Cancer Screening and Knowledge among Womne in South East of Iran. Acta Medica Iranica , 46 (4), 322-328.
 
[18]  Cuzick, J. (2010). Breast Cancer prevention in the Developing World. Breast Cancer Research , 12 (4), 9.
 
[19]  Fikree, M., & Hamade, R. (2011). Breast Cabcer Knowledge among Bahraini Women Attending Primary Health Care Centers. Bahraini Medical Bulletin , 33 (3), 1-8.
 
Show Less References

Article

Health Insurance Technology in Ethiopia: Willingness to Pay and Its Implication for Health Care Financing

1Department of Technology Management, Economics and Policy Program, Room 312, Building 37, 1 Gwanak-ro, College of Engineering, Seoul National University, Seoul, 151-744, South Korea

2College of Business, Law and Governance, James Cook University, P. O. Box 6811, Cairns Qld 4870, Australia


American Journal of Public Health Research. 2016, 4(3), 98-106
doi: 10.12691/ajphr-4-3-4
Copyright © 2016 Science and Education Publishing

Cite this paper:
Birku Reta Entele, Nnaemeka Vincent Emodi. Health Insurance Technology in Ethiopia: Willingness to Pay and Its Implication for Health Care Financing. American Journal of Public Health Research. 2016; 4(3):98-106. doi: 10.12691/ajphr-4-3-4.

Correspondence to: Nnaemeka  Vincent Emodi, College of Business, Law and Governance, James Cook University, P. O. Box 6811, Cairns Qld 4870, Australia. Email: nnaemeka.emodi@my.jcu.edu.au

Abstract

Low-income households in rural areas of Ethiopia are facing catastrophic out-of-pocket health care expenditure due to lack of proper financing mechanism complemented with unexpected health related shock. However, to smooth their health care consumer spending, they need to have a cost-effective health insurance. This study analyzes' Households Willingness to Pay (WTP) for health insurance and the potential market for this cost effective health insurance products. The data used in this study was collected from rural households in East Shewa zone, Adama Woreda, which constitutes about 500 household heads respondents. The Contingent Valuation Method (CVM) with double bounded dichotomous choice (DBDC) elicitation method was used to estimate respondents WTP for proposed health insurance technology. The result of the study shows that households' average WTP (considering their ability to pay) is higher than their cost of public health care and self-treatment per year at a national level on average. Variables such as farm income, frequent visit to the health center, age, education, and insurance cost (premium) are significant determinants of households' willingness to pay. For the hypothetical health insurance scenario, households do have enough willingness to pay to cover cost for public health care consumption expenditure if the payment mode is planned, conducive and once per year. The study implies valuable information for policy makers and concerned stakeholders such as the Ministry of health and different private insurance provider in health care financing.

Keywords

References

[1]  Mehrotra A, Adams JL, Armstrong K, Eibner C, Hussey PS, Lave J, Liu H, McGlynn EA, Pollack CE, Ridgely MS, Rudavsky R. Health care on aisle 7: The growing phenomenon of retail clinics. Santa Monica, Calif.: RAND Corporation, RB-9491-1. 2010.
 
[2]  (FMH) Ethiopia Federal Ministry of Health. April 2014. Ethiopia’s Fifth National Health Accounts 2010/2011. Addis Ababa, Ethiopia.
 
[3]  Asfaw A, von Braun J. Innovations in health care financing: new evidence on the prospect of community health insurance schemes in the rural areas of Ethiopia. International journal of health care finance and economics. 2005 Sep 1;5(3):241-53.
 
[4]  Asenso-Okyere WK, Osei-Akoto I, Anum A, Appiah EN. Willingness to pay for health insurance in a developing economy. A pilot study of the informal sector of Ghana using contingent valuation. Health policy. 1997 Dec 31;42(3):223-37.
 
[5]  Jung J, Liu Streeter J. Does health insurance decrease health expenditure risk in developing countries? The case of China. Southern Economic Journal. 2015 Oct 1;82(2):361-84.
 
Show More References
[6]  Dalinjong PA, Laar AS. The national health insurance scheme: perceptions and experiences of health care providers and clients in two districts of Ghana. Health economics review. 2012 Jul 23;2(1):1.
 
[7]  Panda P, Chakraborty A, Dror DM. Building awareness to health insurance among the target population of community‐based health insurance schemes in rural India. Tropical Medicine & International Health. 2015 Aug 1;20(8):1093-107.
 
[8]  Mladovsky, Philipa. Social capital and enrolment in community-based health insurance in Senegal. Diss. The London School of Economics and Political Science (LSE), 2014.
 
[9]  Carrin G, Waelkens MP, Criel B. Community‐based health insurance in developing countries: a study of its contribution to the performance of health financing systems. Tropical medicine & international health. 2005 Aug 1;10(8):799-811.
 
[10]  Kruk ME, Goldmann E, Galea S. Borrowing and selling to pay for health care in low-and middle-income countries. Health Affairs. 2009 Jul 1;28(4):1056-66.
 
[11]  Macha J, Harris B, Garshong B, Ataguba JE, Akazili J, Kuwawenaruwa A, Borghi J. Factors influencing the burden of health care financing and the distribution of health care benefits in Ghana, Tanzania and South Africa. Health policy and planning. 2012 Mar 1;27(suppl 1):i46-54.
 
[12]  Newhouse JP, Manning WG, Morris CN, Orr LL, Duan N, Keeler EB, Leibowitz A, Marquis KH, Marquis MS, Phelps CE, Brook RH. Some interim results from a controlled trial of cost sharing in health insurance. New England Journal of Medicine. 1981 Dec 17;305(25):1501-7.
 
[13]  Robyn PJ, Hill A, Liu Y, Souares A, Savadogo G, Sié A, Sauerborn R. Econometric analysis to evaluate the effect of community-based health insurance on reducing informal self-care in Burkina Faso. Health policy and planning. 2012 Mar 1;27(2):156-65.
 
[14]  Liu X, Tang S, Yu B, Phuong NK, Yan F, Thien DD, Tolhurst R. Can rural health insurance improve equity in health care utilization? A comparison between China and Vietnam. Int J Equity Health. 2012 Feb 29;11(10):1-9.
 
[15]  Asgary A, Willis K, Taghvaei AA, Rafeian M. Estimating rural households’ willingness to pay for health insurance. The European Journal of Health Economics, formerly: HEPAC. 2004 Sep 1;5(3):209-15.
 
[16]  Wagstaff A, Nguyen HT, Dao H, Bales S. Encouraging Health Insurance for the Informal Sector: A Cluster Randomized Experiment in Vietnam. Health economics. 2015 Jan 1.
 
[17]  Cohodes SR, Grossman DS, Kleiner SA, Lovenheim MF. The effect of child health insurance access on schooling: Evidence from public insurance expansions. Journal of Human Resources. 2015 Nov 30.
 
[18]  Adams R, Chou YJ, Pu C. Willingness to participate and Pay for a proposed national health insurance in St. Vincent and the grenadines: a cross-sectional contingent valuation approach. BMC health services research. 2015 Apr 9;15(1):1.
 
[19]  Mitchell RC, Carson RT. Using surveys to value public goods: the contingent valuation method. Resources for the Future; 1989.
 
[20]  Cameron TA, Quiggin J. Estimation using contingent valuation data from a “dichotomous choice with follow-up” questionnaire. Journal of environmental economics and management. 1994 Nov 30;27(3):218-34.
 
[21]  Haab TC, McConnell KE. Valuing environmental and natural resources: the econometrics of non-market valuation. Edward Elgar Publishing; 2002.
 
[22]  Hanemann WM, Kanninen B. The statistical analysis of discrete-response CV data. Valuing environmental preferences: theory and practice of the contingent valuation method in the US, EU, and developing countries. 1999;441.
 
[23]  Krinsky and Robb. Mean and median willingness to pay measures, updated version 2002.
 
Show Less References