An evaluation of prescriptions dispensed in Malaysian community pharmacies in the absence of dispensing separation

Abstract

The separation of prescribing and dispensing remains a topic of intense debate in many countries without such a separation policy, including Malaysia. While most patients in these countries obtain their medicines from the prescribing physician themselves, some patients may choose to get their prescriptions filled at a community pharmacy. In this study prescription records of community pharmacies were analysed to evaluate utilization of pharmacy dispensing services with reference to prescription rate, origin of prescription, and therapeutic class of medications dispensed. A total of 982 prescriptions from 20 community pharmacies, comprising of 2181 medications, were analysed. The mean prescription rate was 6.13 prescriptions per pharmacy per month. Most of the prescriptions originated from private hospitals (57.0 %), followed by private clinics (28.9 %) and public institutions (12.6 %). The top three therapeutic classes of medication dispensed were cardiovascular (30.3 %), alimentary tract (19.2 %), and antiinfectives (15 %). Chain pharmacies received significantly more prescriptions compared to independent pharmacies. Chain pharmacies were also more likely to receive prescriptions from private hospitals (p<0.001), whereas independent pharmacies were more likely to receive prescriptions from private clinics (p<0.001). Overall, utilization of pharmacy dispensing services remains low in the absence of dispensing separation. Patients that fill their prescriptions at community pharmacies are likely driven by cost factors and on long-term medication. The public should continue to be educated regarding dispensing separation and the options available when obtaining their medication.