Community pharmacists' knowledge and dispensing recommendations for treatment of acute diarrhoea in Trinidad, West Indies.

Using a hypothetical case presentation of a patient with acute diarrhoea, community pharmacists in Trinidad were asked about their knowledge and dispensing recommendations to manage acute diarrhoea. Oral rehydration salts (ORS) were recommended by 86% (79), but more pharmacists would recommend ORS as the first choice therapy alone, for children (70%) than adults (33%) (p < 0.01). Antimotility agents as a first choice therapy alone or with ORS would be given to more adults (60%) than children (10%) (p < 0.01), and more adults (59%) than children (33%) would receive cotrimoxazole. Pharmacists (93%) would counsel on preparation, storage and treatment schedule for ORS, but not on discontinuing (32%) or continuing ORS (4%). Despite 51 pharmacists knowing the WHO guidelines to treat acute diarrhoea, only 23 dispensed in accordance. Educational re-enforcement to manage acute diarrhoea and dispensing practices of medications are necessary for pharmacists who are the first patient contact in Trinidad.

The knowledge and approach of community pharmacists in the management of acute diarrahoea: a survey of nintey-two (92) pharmacies throughout Trinidad - Poster abstract

OBJECTIVE: To determine the awareness of pharmacists in Trinidad of the WHO guidelines for treating acute diarrhoea in children and adults, and if medication was dispensed in accordance with these guidelines. DESIGN AND METHODS: From 220 retail pharmacies a representative sample of 92 pharmacies was randomly selected from the eight counties in Trinidad. Pharmacists were interviewed using a pilot tested questionnaire with hypothetical child and adult cases for which recommendations were invited for treatment. RESULTS: As the first choice of therapy for children, 69.6 percent of the pharmacists recommended oral rehydration salts (ORS), compared with 32.6 percent for adults (p<0.01). For children, 5 (6.6 percent) pharmacists recommended ORS in combination with an anti-diarrhoeal and an adsorbent respectively and 3 (1.3 percent) recommended it with an anti-spasmodic. For adults, 22 pharmacists (37.4 percent) recommended ORS with anti-diarrhoeals, 3 (5.1 percent) with anti-spasmodics and 2 (3.4 percent) with adsorbents and anti-microbials, respectively. Only 51 (55.4 percent) pharmacists interviewed knew of the WHO guidelines. Of those, 89 percent recommended ORS as the first choice of therapy for a child and 64 percent recommended it in adults (p<0.05). CONCLUSION: Pharmacists in Trinidad preferentially recommend ORS as the first choice therapy for acute diarrhoea in children and not in adults. Educational intervention to reinforce the WHO guidelines is recommended since pharmacists are the first patient contact.(AU)