Uganda Pharmaceutical Sector Baseline Survey: ANNEXES: Survey form 7: Public Health Facility Rational Drug Use - Patient Care Form

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	Uganda Pharmaceutical Sector Baseline Survey (HAI, WHO; 2002; 67 pages)
		Foreword
		Acknowledgments
		Abbreviations
		Executive summary
		1. Introduction
			a) Demographic characteristics
			b) Health characteristics
			c) Health policy
			d) Health system structure
			e) The Pharmaceutical Sector
				i) National Drug Policy
				ii) Drug supply system
				iii) Key pharmaceutical indicators
				iv) Pharmaceutical sector surveys
		2. Study Design and Methodology
			2.1 Objectives of the survey
			2.2 Methodology
				a) Level I indicators
				b) List of Level II indicators
				c) List of household survey indicators
				d) Training and Sampling
				e) The survey
				f) Ethical Considerations
		3. Findings
			3.1 Level I: Structures and processes of country pharmaceutical situation
			3.2 Level II: Core indicator results
				a) Summary of the Level II core indicator results
				b) Accessibility to Drugs
				c) Stock-out duration in public health facilities and district warehouses
				d) Percentage of prescribed drugs actually dispensed to patients in public health facilities
				e) Affordability of key drugs in public health facilities and private dispensing drug outlets
				f) Prices of key drugs in public health facilities and private dispensing drug outlets
				g) Quality of drugs
				h) Rational drug use
					i) Number of drugs prescribed per patient contact at public health facilities
					ii) Percentage of patients receiving an antibiotic at public health facilities
					iii) Percentage of patients receiving an injection at public health facilities
					iv) Percentage of prescribed drugs on EDLU in public health facilities
					v) Adequacy of labelling at public health facilities
					vi) Adequacy of patient knowledge of how to take medicines at public health facilities
					vii) Prescribing according to STGs at public health facilities
					viii) Availability of STGs and EDLU at public health facilities
			3.3 Household survey results
		4. Interpretation of Results
		5. Conclusions and Recommendations
			a) Conclusions: Positive aspects and areas for improvement identified
			b) Recommendations Summary
		ANNEXES
			Annex 1: Questionnaire on structures and processes of country pharmaceutical situation (Level I)
			Annex 2: Results of Previous Pharmaceutical Sector Surveys
			Annex 3: Adaptation of survey forms with country specific information for Uganda
			Annex 4: Survey forms
			Survey form 1a: Central/District Warehouse
			Survey form 2a: Central/District Warehouse
			Survey form 3a: Central/District Warehouse: Storage Checklist
			Survey form 1b: Public Health Facility
			Survey form 2b: Public Health Facility
			Survey form 3b: Public Health Facility Storage Checklist
			Survey form 4a: Public Health Facility Pharmacy
			Survey form 4b: Private Pharmacy
			Survey form 5: Private Pharmacy
			Survey form 6: Public Health Facility: Rational Drug Use - Prescribing Indicator Form
			Survey form 7: Public Health Facility Rational Drug Use - Patient Care Form
			Survey form 8: Public Health Facility - Standard Treatment Guidelines/EDL
			Survey form 9: Public Health Facility: Treatment of Diarrhoea, ARI, and Pneumonia
			Survey form 9 (cont.): Public Health Facility: Treatment of Other Tracer Diseases
			Survey form 10: Household

Survey form 7: Public Health Facility Rational Drug Use - Patient Care Form

Indicators:	% of drugs dispensed
	% drugs with adequate label
	% of patients who know how to take drugs

Public Health Facility
Facility #____ (1-30)

Facility _______________________	Date ________________________
Location ______________________	Investigator __________________

Seq. No.	No. of drugs prescribed [A]	No. of drugs dispensed [B]	No. of drugs adequately labelled [C]	Patient has adequate knowledge (yes=1, no =0) [D]
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
Total		Total B =	Total C =	Total D =
Average
Percentage		[B¹]=% dispensed = Total [B]/No. prescribed x100 = ____	[C¹]=% w/adequate label = Total [C]/Total [B] x 100 = ____	[D¹]=% of patients with adequate knowledge = Total [D]/cases asked x 100 = ____

Notes
[A]	Interview 30 patients leaving the dispensing area/pharmacy
[B]	Check how many drugs (chemical entity/INN/generic) were given to each patient
[C]	Check which are adequately labelled (name of drug, dosage and duration plus any additional criteria specified by country). A drug is adequately labelled only if all criteria are met.
[D]	Determine if patient has adequate knowledge about the drugs dispensed. Ask patient if he/she knows how to take each drug. Indicate: (1) If patient can correctly give the name of all drugs or state what the drugs are for and how they should be taken plus any additional criteria specified by country. (0) If the patient cannot give the name of even one drug, cannot state what a drug is for, does not know how to take one of the drugs given, or does not meet any additional criteria specified by country.

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