Universal Medical and Business College

Department of pharmacy

Patient understanding of dispensed drugs and factors

affecting it as Patient Care indicator at Tirunesh Beijing
Hospital Outpatient Pharmacy in Addis Ababa, Ethiopia,
2022.

Name of the investigators: Betelehem Kirose…………PHDR/2006/10

Biniyam Abate……………PHDR/1911/10
Ermias Getachew…….…...PHDR/1941/10
Muhaba Zeynu……….……PHDR/1854/10

A research paper submitted to, Universal Medical and Business College,

Research and Community Service Office, in partial fulfillment for the
requirement for Bachelor of Pharmacy (B.Pharm.) program.
Universal Medical and Business College
Department of pharmacy

Patient understanding of dispensed drugs and factors

affecting it as Patient Care indicator at Tirunesh Beijing
Hospital Outpatient Pharmacy in Addis Ababa, Ethiopia,
2022.

Name of the investigators: Betelehem Kirose………….PHDR/2006/10

Biniyam Abate……………..PHDR/1911/10
Ermias Getachew…….…….PHDR/1941/10
Muhaba Zeynu……….…….PHDR/1854/10

Name of advisor: Jemal Dilebo ( B. pharm, MSc…)

April, 2022
Addis Ababa, Ethiopia.
ACKNOWLEDGEMENT
First and foremost, we want to thank Universal Medical and Business Collage for enabling us to
work on this research, and gain a wealth of information. Next, we would like to extend our
gratitude to instructor Tadesse Alemu (B.Sc., MPH) for his ongoing assistance with our research
and for providing us with a wealth of expertise regarding epidemiological study designs and
statistics. Additionally, we would want to express our gratitude to our adviser, Jemal Dilebo, for
his continuous support of our study, as well as his patience, inspiration, and vast expertise. His
advice was invaluable during the research and preparation of this proposal. For our research, we
could not have asked for a finer adviser and mentor. We appreciate the efforts of the public
relations information centers at TBGH Hospital, for being cooperative in providing information
that was useful to our research. Last but not the least, we would like to thank our family and
friends for their limitless support.

I
 TABLE OF CONTENTS
CONTENTS PAGE

Acknowledgement ……………………………………………..…………………I

List of figures and tables…………….…….………………………………...........IV

List of acronyms and abbreviations………………. …………………..…………V

Summary/Abstract…………………………………………………...……………VI

1. Introduction………………………………………………………..………….1

1.1 Back Ground of the study…………….………………………………………1

1.2 Statement of the problem……………………………………………………...3

1.3 Significance of the study ………………………………………………..……6

2. Literature review………...…………………………..………………..………7

3. Objectives………….………………………………………………..…………15

3.1 General objective……………………………………………………….…….15

3.2 Specific objectives……………………………………………………...…….15

4. Methods & Materials……………………………………..……..…………….16

4.1 Study area and study period…………………………………………………..16

4.2 Study design…………………………………………………………………..1

4.3 Population…………………………………………………………………….17

4.3.1. Target Population………………………………………….……………….17

4.3.2. Source population…………………………………………………………..17

4.3.3 Sample population…………………………………………………………..17

4.3.4 Inclusion criteria……………………………………………………………..17

4.3.4 Exclusion Criteria……………………………………………………………17

4.4 Sample size determination……………………………………..………………17

4.5. Sampling procedure…………………………………………………………...18

II
4.6. Study variables…………………………………………………………….....18

4.6.1 Dependent variables……………………………………………….………..18

4.6.2 Independent variables………………………………………………...…….18

4.7. Data collection procedures……………………………………..…………….19

4.7.1 Data collection instrument………………………………………………….19

4.7.2. Data collection methods……………………………………………………20

4.7.3. Measurements of patient care indicators…………………………………...20

4.7.4. Data collectors………………………………………………………..…….20

4.8. Data processing and analysis……………………………………….………...20

4.9. Data quality management and assurance……………………….……………21

4.10. Operational definition………………………………………………………21

4.11. Ethical considerations………………………………………………………22

4.12. Dissemination plan…………………………………………………………22

5. Results……………………………………………………………….……........23

5.1 Socio-demographic characteristics of Respondents………………………….24

5.2 Pharmacy service provision and interaction characteristics of respondents….25

5.3 Patient understanding of Dispensed Drugs…………………………………...27

5.3.1 Overall knowledge Score…………………………………………………...29

5. 4 Factors affecting patient understanding of dispensed drugs…………………29

6. Discussion……………………………………………………………………...31

7. Strength and limitation……………………………………………………….33

7. Conclusion and recommendation…………………………………………....34

8. References……………………………………………………………..…..…..35

Annexes..……..………………………………………………………………..…41

III
LIST OF FIGURES AND TABLES Page

Figure1. Location map of TBGH………………………………………………………...16

Table 1 Socio-demographic characteristics of the patients at Tirunesh Beijing General Hospital

from May 09, 2022 to May 31, 2022, Addis Ababa, Ethiopia……………………24

Table 2 Pharmacy service provision and interaction characteristics of respondents at

Tirunesh Beijing General Hospitals’ outpatient pharmacy from May 09, 2022 to May 31,
2022, Addis Ababa, Ethiopia……………………………………………………...26

Table 3 Patients’ understanding of their dispensed medication at the outpatient pharmacy

of Tirunesh Beijing General Hospital from May 09, 2022 to May 31, 2022, Addis Ababa,
Ethiopia……………………………………………………………………………28

Table 4: Patient knowledge scores for dispensed drugs at the outpatient pharmacy of
Tirunesh Beijing General Hospital from May 09, 2022 to May 31, 2022, Addis Ababa,
Ethiopia……………………………………………………………………………29

Table 5 Regression analysis for factors affecting patients’ understanding of their dispensed
drugs at the outpatient pharmacy of Tirunesh Beijing General Hospital from May 09, 2022
to May 31, 2022, Addis Ababa, Ethiopia…………………………………………30

IV
LIST OF ACRONYMS/ABBREVIATIONS

 AAHB, Addis Ababa Health Bureau.

 DIC, Drug information center.
 ICU, Intensive care unit.
 NICU, Newborn intensive care unit.
 OP, Outpatient.
 PHC, Primary health care.
 PMK, Patient medication knowledge.
 RCEO, Research and community engagement office.
 SPSS, Statistical Package for the Social Sciences
 TBGH, Tirunesh Beijing General Hospital.
 WHO, World health organization.

V
ABSTRACT

Background (statement of the problem): Insufficient knowledge of patients about their

dispensed medications could result in inappropriate use of medication which can lead to
treatment failure and poor therapeutic outcome.

Objective: The aim of this study is to assess patient understanding of dispensed drugs and
factors affecting it at Tirunesh Beijing General Hospital (TBGH) outpatient pharmacy in Addis
Ababa, Ethiopia 2022.

Method: A Hospital-based cross-sectional study will be employed among patients attending in

the outpatient pharmacy of TBGH. The data collection technique is a face-to-face interview by
using a semi-structured questionnaire. The SPSS version 26 will be used to calculate descriptive
statistics, as well as univariable and multivariable logistic regression.

Result: A total of 380 patients participated in the study with a 100% response rate. Of the total,
147 (38.7%) patients had sufficient exit-knowledge about their dispensed medication. Patients
who are illiterate had 0.26 times sufficient knowledge than those of literate (95% CI: 0.116-
0.582). Participants who visited the pharmacy repeated times were found 1.913 times more likely
to have sufficient knowledge in comparison to those who visited only once (95% CI: 1.177-
3.108). Also, the odds of sufficient exit-knowledge was 0.138 (95% CI: 0.032‒0.599) and 0.484
(95% CI: 0.050 ‒4.697) times lower in those who responded “I got not enough information from
the pharmacist” and “neutral”, in comparison to those who responded “I got enough information
from the pharmacist”, respectively.

Conclusion and recommendation: Less than half of the patients had sufficient exit knowledge
of the medications that were prescribed to them. The exit-knowledge was substantially correlated
with the patient's education status, visit frequency, and opinion of the pharmacists' advice
regarding its sufficiency and clarity. Dispensers should take extra care with those individuals
who have low educational levels, and pharmacists should receive better communication skills
and trainings for the just implemented new dispensary system.

Keywords: Patient understanding, exit-knowledge, outpatient pharmacy.

VI
1. INTRODUCTION

1.1. Background of the study

Rational drug use is a concern in both developed and developing countries during the last two
decades and are promoted by World Health Organization (WHO) and others. Within drug use
programs, efforts have often been targeting ensuring rational prescribing habits (1). One of the
essential prerequisites for the optimal use of medicines is sound patient knowledge about
prescribed medications. According to the standard medicine use indicators set by (WHO), the
patients’ knowledge of their treatment regimen is an important patient care indicator. In the
evaluation of patients’ knowledge of medicines, the following are considered as essential
parameters for safe and effective use; the names of the medicines, the purpose of therapy, the
duration of therapy, the dose and frequency of administration and important side effects. WHO
defines the rational use of medicines as ensuring that a patient receives medications appropriate
to their clinical needs, within the right dose, for an adequate duration of therapy, and at the
proper cost to the patient and their community (2).

Patients’ medication knowledge has been defined as the awareness of the drug name, purpose,
administration schedule, adverse effects or side effects or special administration instructions (3).
Labeling and knowledge of dispensed drug is crucial for the patient to identify the contents and
to ensure that they have clear and concise information about the use of dispensed drugs. Lack of
this may lead the patient to incorrect use, which in response results in an adverse effect (4).

There are many medication options for each patient, and choosing the simplest one requires a
patient-physician shared decision-making process in which the prescriber and patient discuss the
proposed treatment, its potential benefits and drawbacks, and the need for careful monitoring and
dosage adjustment. Patients' happiness with their care, as well as how effectively they follow
medical recommendations, may be influenced by information presented to them during medical
visits. Patients who receive better drug information and instructions on how to take their
prescriptions are more likely to stick to their treatment regimen. In general, it is expected that
patients would be able to comprehend written and spoken information. Patients who do not
comprehend health information are unable to take the essential steps to improve their health (5).

1
A growing number of studies suggest that patients have a requirement for information and
support regarding their medicines. Approximately 40% of patients who are discharged from
hospital may subsequently experience medicines-related problems, including medicines-related
errors. Findings indicate that patients often lack knowledge about their medications following
hospital discharge which many patients report not receiving important medicines-related
information. WHO policy states that offering information on medicines via medicines
information centers and providing public education about medicines, are two of 12 essential
interventions to market the rational use of medicines. Therefore, medicines information services
are established in many countries to support patients and therefore, the general public with their
medicines (6).

A considerable percentage of outpatient medication mistakes are thought to be the result of

patient noncompliance, which might be related to medicine name and sound misunderstanding.
Nearly half of patients couldn't understand one or more of the label instructions for five common
prescription medications in a research. Prescription medicine labeling issues were notably
mentioned as a key root cause of a high percentage of the cases. Patients may accidentally
misuse a prescription medicine, resulting in outpatient medication mistakes and adverse
outcomes, due to a misunderstanding of the instructions. The standard size of paper envelops for
labeling in Ethiopia does not even allow the needed medication information to be written on it
(7).

2
1.2. Statement of the problem

Drug use is effective when patients receive the acceptable drug(s) in dose(s) correct to their
individual requirements, for an optimum period of time, and at the lowest cost to them and
therefore the community. Any mistake made throughout the dispensing and labeling process
could jeopardize patient care. Because pharmacists are the primary dispensers of medicines, they
are responsible for reinforcing patient awareness about their given prescriptions (8). According
to a previous study, poor prescribing and dispensing methods resulted in 50% of patients not
taking their drugs appropriately. A large portion of the world's population lacks access to basic
medical care. These issues could result in incorrect patient medication demands, lower
attendance rates due to out-of-stock medicine, and a loss of patient trust in the healthcare system.
To benefit patients, good prescribing practice necessitates educated collaboration between
physicians and pharmacists. However, just a few research have looked into patient care methods
within community pharmacy setting (9).

Counseling at the time of delivering the prescription medicine is the most basic kind of patient
education. Patients should know how to take their medicine, how often they should take it, what
to do if a dose is missed, what adverse effects to watch for, and how to keep it. It is frequent in
Ethiopia for administered pharmaceuticals to be found without a label, with an incomplete label,
or with illegible labeling. The average consultation time in minutes was 5.1 and 5.8 while, the
dispensing time in minutes was 1.5 and 1.9, in a study on rational drug use in nine health centers
and nine health stations in North West Ethiopia. The WHO, on the other hand, had an average
consultation time of 10 minutes and an average dispensing time of 180 seconds. The most likely
explanation for this variation in dispensing time may be due to manpower, set up with dispensary
area and ease of access for essential materials like drugs, medical equipment among health
centers (4). In a research conducted in Ethiopia, the majority of participants stated that they did
not know "how to take prescriptions," that they were "missing dosages," and that they did not
know "what to do if side effects arise with medications." Only a few of them were able to explain
in general terms the actual mechanism of action of their drugs (10). Failures in communication
between patients and healthcare providers might result in gaps in the treatment process
continuity (11).

3
Patients expend excessive costs as a result of medication errors caused by incorrect use of
medications and a lack of awareness. According to a previous study, every avoidable adverse
medication reaction costs more money. Overuse and misuse of drugs are also contributing to the
rise in antimicrobial resistance, particularly in low-income nations. Different studies have
revealed exit knowledge of patients on their dispensed medication isn’t optimal. A study from
Israel revealed that 36% and 60% of the patients didn’t receive adequate information on their
previous and new medications, respectively. Likewise, a study from Gondar, Ethiopia illustrated
that adherence is significantly associated with good knowledge of dispensed medications. Other
studies conducted in Ethiopia revealed that the exit knowledge on dispensed medications was
38.6% in Eastern Ethiopia and 46% in Hiwot Fana university specialized hospital (12). Patients'
inability to understand instructions due to a lack of oral and written information from doctors
and/or pharmacists on the prescribed drug has resulted in therapeutic failure. According to
studies, 46% of patients misread one or more dose instructions and 56% misunderstood one or
more supplementary warnings, respectively (13).

According to another study, adult patients were 3.7 times greater exit-knowledge than the elderly
patients. Participants who were residing within the populated area were 3.7 times more likely to
have sufficient knowledge of dispensed medication than those from the rural. Similarly, female
patients has less-sufficient exit-knowledge than males (14). Several variables contribute to non-
adherence, three of which are particularly important: treatment complexity, cognitive decline,
and patient communication. The literacy educational levels of elderly patients (>65 years) are
often lower than those of younger patients. As a result, older people may have trouble reading
and comprehending drug labels and directions, as well as remembering prescriptions.
Furthermore, because they are more likely to have many chronic diseases, they are given more
complicated prescription regimens than younger patients, which increases the risk of non-
adherence (15).

Evidence suggests that having a high level of patient medication knowledge (PMK) leads to
improved treatment outcomes and a greater ability to detect potential side effects associated with
the use of such products, hence increasing the safety of pharmacotherapy. Insufficient PMK, on
the other hand, can lead to poor adherence to treatment, underutilization of pharmacotherapy,
and a variety of negative consequences such as increased morbidity, hospital admissions, and

4
additional treatment expenditures, as well as mortality (16). Since the percentage of adult
population who lack the essential skills for reading and processing health related information in
developing countries is expected to be higher, poor understanding of prescription labels might
link to poor outcomes, increased health costs, patient dissatisfaction with health care providers,
adverse drug events and a burden on health care (17).

Multiple factors can affect patient knowledge and thus, adherence to their treatment including
doctor patient communication, pharmacist-patient communication, patients age, gender, level of
education, income, primary language, nature of illness (18). In addition, several factors affect the
dispensing practice of pharmacists, such as the language barrier, the pharmacists commitments,
knowledge and experience as well as the dispensing room environment (14). There are also
several obstacles that make it difficult to educate patients, such as the overburdening of health
professionals, doctors' insufficient knowledge, patients' low health literacy levels, and patients'
lack of interest in learning about the medications they are prescribed (2).

There is a scarcity of data on patient medication knowledge and associated factors in primary
care patients, particularly in developing nations. Studies that assess patients knowledge about
their dispensed medication at outpatient setting are quite sparse in Ethiopia. Despite the fact that
several health facilities dispense prescription pharmaceuticals, no such study has been conducted
in the outpatient pharmacy of Tirunesh Beijing General Hospital.

5
1.3. Significance of the study

In most Ethiopian health facilities, insufficient attention is paid to the labeling of dispensed
prescriptions, resulting in patients' misunderstanding of how to utilize the medications they have
been given. This leads to patient non-adherence to their medication, resulting in poor treatment
outcomes. On the other hand, a patient's understanding of distributed drugs is vital for a good
treatment outcome since it enhances the patient's awareness of how to use their drugs.

Therefore, by identifying crucial areas that need to be addressed and knowing the state of the
outpatient pharmacy with regard to the patients’ understanding of dispensed drugs at Tirunesh
Beijing hospital, this study will contribute to the benefit of both the patients and health-care
professionals, as well as the health-care system, In addition, the research findings will aid in the
improvement of pharmacy operations. Furthermore, it can be used as a starting point for larger-
scale investigations at the regional and/or national levels.

6
2. LITERATURE REVIEW

Patients’ medication knowledge has been defined as the awareness of the drug name, purpose,
administration schedule, adverse effects or side effects or special administration instructions.
Labeling and knowledge of dispensed drug is crucial for the patient to identify the contents and
to ensure that they have clear and concise information about the use of dispensed drugs. Lack of
this may lead the patient to incorrect use, which in response results in an adverse effect.

Of the 100 patients that were approached, 90 agreed to be included in the study performed in
Saudi Arabia, April, 2013. Also, 45.6% of the patients said they had previously undergone
counseling. As mentioned in the study, there was no significant relationship between the patients'
educational level and their gender. The patients' educational level, on the other hand, was shown
to be substantially related to their age. Furthermore, medication identification, indications,
scheduling, and side effects were all substantially linked to previous counseling. Finally,
individuals who had previously received counseling demonstrated good to outstanding awareness
and indications of the drugs they had been given (19).

A total of 412 patients were recruited in a research from two general outpatient clinics and two
medical outpatient clinics in Hong Kong, China in 2013. Also, 3.75 ± 1.93 drugs were taken on
average by each patient. Overall, 52.7% of patients thought healthcare staff or clinic pharmacists
had very clearly explained the administration instructions for prescribed medications, while
47.9% thought they had very clear explanations of drug purpose, but only 11.4% thought they
had very clear explanations of side effects. 396 patients (96.1%) were unable to recall any
adverse effects or precautions associated with each of their given drugs, despite the fact that 232
patients (58.4%) said they would seek medical advice if they had issues with their medications.
The likelihood of patients recalling adverse effects of all drugs provided decreased by 35% for
every additional prescription supplied. Furthermore, people who completed secondary school or
higher education were more likely to be aware of negative effects (3).

Detailed examination of patients knowledge regarding their dispensed medication in a south

Indian government hospital in March, 2015 using a direct observational study showed that, out
of 167 patients, 58% were able to identify medicines by their color, shape, and size of tablets and
syrups, while only 42% were able to identify by their names; 67% are willing to stop taking

7
medicines if they feel better without consulting their doctor; 71.4% don't even know what drugs
have been prescribed for what condition; 64.8% believe that drugs are magical cures for any
disease; 43% patients suggest that drugs are magical cures for any disease; 64.8% patients
suggest that drugs, aside from this, 86.7% believe that medicine information is critical to their
overall health (20).

A descriptive crosscut (transversal) study carried out in volunteer 35 community pharmacies on

the Greater Lisbon Metropolitan Area, in Portugal November, 2015. Patient’s knowledge was
assessed in four dimensions: therapeutic objective, process of use, safety and maintenance of the
medications that the patient takes. Thirty-five pharmacies participated, and 633 valid patients
were obtained. 82.5% were unaware of the drug's nature. Additionally, there was a significant
number of patients with inaccurate information on all topics, with an emphasis on precautions
(44.7% ). "Drug safety" was the factor that the patients were least aware of (1.9%). Eight out of
ten patients have no idea what medicine they are taking. Lastly, the "safety" of the medicine was
the area where the most incorrect information was found (21).

A cross-sectional survey was undertaken in community pharmacies across the Spanish territory
in October 2016. 7278 patients took part in the research. 71.9% of the questioned patients had
insufficient understanding of the drug they were taking. The 'medicine use procedure' and the
'therapeutic goal of medication' were the aspects with the greatest amount of understanding. The
items with the highest proportion of knowledge were 'frequency' (75.4%), 'dosage' (74.5%), and
'indication' (70.5%). In contrast, 'medication safety' had the lowest scores, ranging from 12.6%
for the item "contraindications" to 15.3% for the item "side effects." (22).

A comparable study was conducted with a convenience sample of patients from six U.S. primary
care clinics in 2017. 30% of patients couldn't name at least one of their prescriptions; 19% had
no idea what they were for; and 30% had misunderstandings about one or more medications'
purposes. Between patients who used medi-sets, pre-packaged rolls, or blister packs and patients
who stored pills in their original containers, or across demographic groups, there was no
significant difference in ability to name medications or state their medication's purpose (23).

A research was conducted in three metropolitan community pharmacies across Adelaide, South
Australia in 2018. 40 participants agreed to be involved in the study, also their average age was

8
76.7years (65– 97). According to the survey, 82.5% of participants said they recognized the
names of some or all of their medications, and 75% said they could visually identify all of their
medications. However, 25% of individuals couldn't visually distinguish their medications, or
could only recognize some of them based on their size or color. When asked if they check their
medicine every time their prescription is filled, 85% of responders said yes. However, the
majority of participants were unable to explain the indication for which each prescription was
prescribed, nor were they aware of any drug interactions (24).

From January to March 2020, a cross-sectional qualitative survey was done across Bangladesh's
several regions. More than 26% of patients couldn't name the brand name of all their
prescriptions, but the proportion of patients who didn't know the generic names was much higher
(88.1%). Nearly one out of every four patients had no idea what their prescriptions were for, and
more than half of the participants (55%) had no idea what their meds' doses were. While
knowledge of pharmaceutical routes and regimens was adequate, understanding of medicine's
risk factors was the least. Only one out of every four patients reads the medication information
sheet. Finally, the capacity of patients to accurately explain the purpose of their drug was shown
to be favorably related to age and negatively related to the number of medications taken (25).

An observational, cross-sectional study was conducted in the Medicine Outpatient Department

(OPD) and pharmacy of a tertiary care, teaching hospital in Delhi, India 2020. The study showed
that Among 500 patients interviewed, The mean total score for drug knowledge across patients
was 38.87 ± 10.42 (maximum 60). 95% of those who took part had 'Adequate to Good
Knowledge,' while 5% had 'Poor Knowledge.' Only 1.8% of the patients polled were completely
aware of the drugs they were taking. Accordingly, lower scores were connected with age > 60
years, female gender, illiteracy, inability to read English, the doctor only notifying the patient in
writing, and the pharmacist not providing the pharmaceutical information. The average time for a
consultation was 284.6 172.87 seconds, while the average time for dispensing was 60.45 22.3
seconds (18).

A cross-sectional study of 522 elderly patients at 22 public primary care facilities in Vitória da
Conquista, Bahia, Brazil 2021, comprising 15 Family Health Units (FHUs) and 7 Basic Health
Units (BHUs) in 2021 found that 106 individuals were removed from the study owing to
inconsistencies with the study. A total of 38.2% of the remaining 416 had misunderstood drug

9
dosing regimen directions. Misunderstanding of medication dosage regimen instructions was 65
percent higher in illiterate participants, 33% higher in people who thought their memory was
poor, 48% higher in those who did not have a job at the time of the interview, and 82 % higher in
the elderly older dependent in their instrumental activities of daily living. In the case of
polypharmacy, patients who were prescribed five drugs were 50 % more likely to misinterpret
medication dose regimen instructions (26).

According to an exit-survey conducted with a representative sample of 1221

patients (≥ 18 years) interviewed after dispensing in the context of PHC in the Brazilian
Healthcare System 2021. The prevalence of insufficient medication knowledge was 30.1%.
Furthermore, the biggest percentage of misses was seen in side effects (96.3%) and warnings
(71.1%). Drugs for the musculoskeletal system had the lowest knowledge score (mean = 5.9; SD
= 1.9). Finally, level of education, number of comorbidities, use of prescription drugs in the
previous 15 days, and number of people able to lend money were all significant determinants of
insufficient medication knowledge (16).

A similar study conducted on a patient awareness of drugs provided from Ghanaian community
pharmacies in 2013, 280 clients were purposefully sampled to evaluate the quality of labeling.
Antimalarials made up 17.9% of the drugs given out to the 280 individuals interviewed, while
analgesics made up 15.4%. In 98%, %, 55%, 54%, 6%, and 2% of the dispensed drugs, the name,
quantity, dose, frequency, duration of therapy, and route of administration were all indicated on
the label. The average labeling score was 3.096 (SD=1.05) out of a possible 6 points. Patient
knowledge scores were 63%, 80 %, 80 %, %, 57%, and 86 %, respectively. The average
knowledge score was 4.375 (SD: 1.38) out of a possible score of 6 (27).

Of the 336 patients who took part in a cross-sectional research in rural Gambia in 2014, 135
(40.2%) had no education, 128 (38.4%) had informal education, 23 (6.7%) had elementary
education, and 39 (11.6%) had secondary education. Of the 571 patient responses to the purpose
for which medicine was administered, 98 (17.2%) could recall the purpose of their supplied
medicines accurately, whereas 473 (82.8%) could not. Only 31 people (5.4%) properly
remembered the length of therapy. Conclusively, just 92 (16.1%) of patients in rural Gambia had
"excellent" levels of knowledge, whereas 479 (83.9%) of patients had "low" levels of
understanding of their administered medicine (28).

10
For the assessment of individual drug labeling and patient awareness in tertiary hospitals in
Ethiopia 2014, a single institution based cross sectional study design was adopted. The study
found that males and females made up 262 (61.5%) and 164 (38.5%) of the 426 patients,
respectively. The bulk of the participants were between the ages of 18.44 and 45.65. The
majority of patients (79.9%) were literate at various levels of education, while 20.9% were
illiterate. The least amount of patients at pharmacies remembered the "name of drug" out of all
the knowledge qualities. Other aspects of most medications provided, on the other hand, were
remembered by the vast majority of patients. Patients with a reading level of 9 to 10 grades had
the highest knowledge score ( 4 on 5 scales). However, the majority of patients in both literacy
groups did not recall the names of the drugs they were given (29).

According to a cross-sectional study done on Importance of labelling and patient knowledge to

ensure proper care during drug dispensing in Jimma town 2014. Patients with a literacy status of
9 to 10 grades had the highest knowledge score among the 426 patients (4 on 5 scales).
According to the report, 85.4% and 86.4% of the medications administered had their dose and
frequency of administration recalled, respectively. However, the majority of patients in both
literacy groups could not recall the names of the medications they were given. (30).

A facility based cross-sectional study was conducted in May, 2014 at Shambu primary hospital,
Southwest Ethiopia. A total of 400 patients were included. The current study found that 293
(73.3%) of the study participants misinterpreted one or more dose regimen instructions, while
264 (66%) of the patients misunderstood medication administration frequency. Furthermore, 273
(68.25%) were administered without a medicine label based on medication label observations.
Age, educational level, and place of residence all played a role in misunderstanding dose
regimen directions (31).

A study on drug labeling and patient knowledge of dispensed drugs at Adulala Health Center's
outpatient pharmacy in September, 2015, found that a total of 302 patients were included in the
study. The dose was known by all of the patients, and the frequency was known by the majority
(79.06%). In addition to educational status, patient knowledge of prescribed medications is
strongly associated with age. In contrast, there is no link between sex and patient understanding
of prescribed medications. Since the result has an impact on patient satisfaction and enablement.

11
Because dispensing time included dispensing counseling time, during which pharmacists counsel
the patient, the outcome has an impact on patient satisfaction and enablement (4).

A cross sectional study design was employed in the research done in Ethiopia, Hiwot Fana
specialized university hospital, Harar town, Eastern Ethiopia 2017. Only around half of the 422
ambulatory patients could recall the medication's name, severe adverse effects, or what to do if
they missed a dose. In addition, patients with a primary, secondary, or tertiary education who
thought the pharmacist's instructions were clear, who thought the pharmacist's behavior was
polite, and who thought the pharmacist's voice and tone were clear demonstrated a greater
knowledge of their dispensed drugs when they left the outpatient pharmacy. However, when
compared to single patients married patients' awareness of administered medications was much
lower (8).

According to a cross-sectional study conducted to assess the exit knowledge of ambulatory

patients about medications dispensed in a government hospital in Eastern Ethiopia 2018, only
38.6% of the patients met the predetermined criteria and were thus regarded to have enough
knowledge, Also, at least half of the patients remembered the required information related to
their medication frequency of use (82.9%), route of administration (82.5%), expected therapeutic
outcome (63%), storage conditions (54.9%) and drug interactions (54.7%). In contrast, only 37.2,
33.4, and 28.7% of patients could recall the name of the medicine, potential toxicities, and steps
performed in the event of missed doses, respectively.. Patients who spoke Afan Oromo and were
rural inhabitants had significantly lower exit knowledge of the dispensed drug(s) than patients
who spoke Amharic and were urban residents, respectively (32).

According to a cross-sectional study conducted at Nekemte Referral Hospital in Ethiopia 2018,

270 (67.84%) of patients' prescriptions were delivered without a label, while just 128 (32.16%)
were labeled. Twenty-three patients (37.17%), 34 (54.84%), and 52 (83.87%) misinterpreted
dosing regimen directions, respectively, were 45-54 years old, females, and those who couldn't
read or write. The study also found that misunderstanding of dose regimen instructions is more
common for drugs that were not labeled. In conclusion, education status had a significant
relationship with misunderstanding of dose, misunderstanding of frequency, and duration of
treatment, and sex characteristics had no relationship with misunderstanding of dose (33).

12
Patients' medication knowledge and adherence to their oral medications were studied in another
research done at 19 community pharmacies in Gondar town in January, 2020. In a test of
medicine knowledge, 77.6% properly stated the names of their current drugs, 54.2 % correctly
listed the reasons for taking the medications, and 51.2 % correctly listed how to take the
medications. Only 5.7 % of patients, on the other hand, could describe the actual mechanism of
action of their drugs in basic terms. Furthermore, there were no changes in medicine knowledge
based on sex or treatment duration. Medication adherence was also strongly linked with good
medication knowledge ratings. Through the investigation, it is confirmed that knowledge about
chronic oral medications was not good and most of the patients were not adherent to the
medications (17).

An institutional-based cross-sectional study was done among ambulatory patients visiting Ayder
Comprehensive Specialized Hospital's outpatient pharmacy in Mekelle, Ethiopia in 2020. A total
of 400 patients were included in the trial. It was found that the overall sufficient knowledge was
81%. Less than half of the patients remembered the name of each medicine (44.5%) and the
primary negative effects (31.2%). Also, it was discovered that patients with a single marital
status were 4.454 times more likely than widowed individuals to have sufficient exit-knowledge
of their given medications. Furthermore, those who responded "I got enough information from
the pharmacist" and "I did not get enough information from the pharmacist" had 8.995 and 3.377
times higher odds of having sufficient exit-knowledge, respectively, than those who responded "I
do not know" (12).

A hospital-based cross-sectional study was designed to examine the exit knowledge of dispensed
medications among patients attending in outpatient pharmacy of Chencha Primary Level
Hospital, southwest Ethiopia 2020. A total of 403 patients who had their prescription filled at an
outpatient pharmacy participated in the study. Fifty-three (13.2%) patients had adequate
knowledge on dispensed medication. More over half of the patients (58.8%) said they were
counseled in a language they didn't understand (not clear), despite the fact that the great majority
of participants (78.7%) got less than three drugs from the outpatient pharmacy. To summarize,
respondents who were served by pharmacists were nearly ten times more likely than those who
were serviced by pharmacy technicians to have appropriate understanding of dispensed medicine
(34).

13
In an institution-based cross-sectional study conducted at Dessie referral Hospital outpatient
pharmacy 2020. It was discovered that more than half of the 297 patients (77.34%) misread the
dosage instructions. Misunderstanding of dosing instructions was shown to be more common in
labeled (written) medications than in unlabeled medications, according to the findings of this
study (verbal labels). Educational status was found to have a significant impact on patient
misunderstanding of the dose, frequency, and duration misunderstanding (13).

In a hospital-based cross-sectional study done on exit-knowledge about dispensed medications in

Ambo General Hospital, Ethiopia 2021. In terms of the total, 222 (55.5%) patients had sufficient
exit-knowledge about their dispensed medication. Only 51.2% of patients were comfortable with
the dispensing room waiting area. The majority of the participants remembered the medicine's
name, drug indication, route of administration, frequency, appropriate handling of the
medication, how to administer the medication, action taken for a forgotten dosage, and predicted
therapeutic response, according to the research. The individuals' exit knowledge of the duration
of therapy (178, 44.5%), drug interactions (46, 11.5%), and possible toxicities (32, 8%) of the
supplied medicine, however, was low. In general, participants who stated that the waiting space's
comfort was not adequate had lower chances of having sufficient exit-knowledge than those who
claimed that the waiting area was suitable (14).

To summarize, less than half of the participants have a thorough understanding about their
dispensed medicines. Individuals who had previously received counseling demonstrated good to
outstanding awareness and indications of the drugs they had been given. Although most patients
failed to recall any side effects or precautions of each of their prescribed medications. In
addition, most of the patients couldn't name at least one of their prescriptions; they had no idea
what they were for; and had misunderstandings about one or more medications' purposes and
frequencies. Besides, age; educational level; place of residence; marital status; employment
status; payment status; perceived severity of illness; perceived language clarity; number of visits;
and dispensing process-related aspects (dispenser qualification, dispenser work experience,
dispensing time and number of medicines dispensed) are so far some of the factors affecting
patients exit-knowledge of their dispensed drugs.

14
3. OBJECTIVES

3.1. General objective

 To assess patient understanding of dispensed drugs and factors affecting it at Tirunesh

Beijing General Hospital (TBGH) outpatient pharmacy in Addis Ababa, Ethiopia 2022.

3.2 Specific objectives

 To determine the patients’ overall understanding of their administered medications.

 To examine the factors associated with patients’ understanding of dispensed drugs.

15
4. METHODS & MATERIALS
4.1. Study area and period

Addis Ababa is the capital and largest city of Ethiopia. It is located on a well-watered plateau
surrounded by hills and mountains in the geographic center of the country. The current metro
area population of Addis Ababa in 2022 is 5,228,000, a 4.43% increase from 2021. The current
population of Ethiopia is 119,913,931 as of Thursday, March 31, 2022, based on Worldometer
elaboration of the latest United Nations data. In Addis Ababa, there are 96 health centres, 11
public hospitals and 28 private hospitals. Addis Abeba Health Bureau (AAHB) currently
manages six hospitals in Addis Abeba which are Zewditu Hospital, Gandhi Memorial Hospital,
Yekatit 12 Hospital and Medical College, Menelik II Hospital, Ras Desta General Hospital and
Tirunesh Beijing General Hospital (TBGH). TBGH was established in January of 2013. The
hospital currently has 24 beds in the Medical ward, 20 beds in the Pediatrics ward, 33 beds in the
Surgical ward, 18 beds in the Gynecology ward, 5 beds in the ICU, 22 beds in the NICU, and 35
beds in the Labor ward, for a total of 157 beds. There are around 424 healthcare professionals
employed at the facility. Its present address is Addis - Adama Express Way, Addis Ababa in
Akaki Kality Subcity. This study was conducted at Tirunesh Beijing General Hospital’s
outpatient Pharmacy, from May 09, 2022 to May 31, 2022 G.C.

Figure1. Location map of TBGH.

16
4.2. Study design

A hospital based cross-sectional study design was used to assess patients understanding of
dispensed drugs and factors affecting it at selected outpatient hospitals in Addis Ababa, Ethiopia,
2022.

4.3. Population

4.3.1. Target population

All clients who visited TBGH in Addis Ababa, Ethiopia, 2022.

4.3.2. Source population

All clients who visited TBGH to get health care services during the data collection period.

4.3.3. Sample population

Patients and/or caregivers who received pharmaceutical services at TBGH’s outpatient

pharmacy, and those who participated in the interview during the data collection period.

4.3.4 Inclusion criteria

 Clients who were at least 18 years old, both sexes

 Patients with their prescriptions filled at the two hospital's outpatient pharmacy
 Patients and caregivers who were willing to participate
 Those who were able to communicate and were conscious.

4.3.4 Exclusion Criteria

 Patients with cognitive and hearing impairment

 All very ill patients and those who got more than three medications from the outpatient
pharmacy were excluded, since their ability to recall and retain information was
considered to be influenced by their disease condition and the number of medications
they received, respectively.

4.4. Sample size determination

17
 ( ) ( )
The sample size was calculated using the single population proportion formula, n= ,

where:

 n is the minimum sample size required for, a very large population (N>10,000).
 α is the level of significance
 p is best estimate of population proportion, P=0.555
(55.5%) sufficient knowledge reported from a study conducted in Ambo General Hospital
(14).
 w is maximum acceptable difference ( marginal error tolerated, 0.05).
 is the value under standard normal table for a given value of confidence level (95%).

( ) ( )
Therefore, n= = 380.
( )

The sample size was 380. Patients who met the inclusion criteria were selected from the source
population.

4.5. Sampling procedure

The total number of patients expected to visit the outpatient (OP) pharmacy during the course of
the 22 day trial period was calculated. According to the hospital’s outpatient pharmacy record
books, an average of 2200 patients were entered in the outpatient pharmacy within the 22 days.
On average, 100 patients per day visited the outpatient pharmacy of TBGH. On average, at least
15 patients were interviewed daily at the pharmacy. A probability simple random sampling
technique was used to select the samples from the source population.

4.6. Study variables

4.6.1. Dependent variables

Level of patient understanding of dispensed drugs.

4.6.2. Independent variables

 Age

18
  Educational level
 Place of residence
 Marital status
 Employment status
 Payment status
 Perceived language clarity
 Number of visits and
 Dispensing process-related aspects (dispenser work experience, dispensing time and
number of medicines dispensed).

If a patient properly answered at least eight of the twelve questions used to test the patient's
understanding of administered medications, he or she was considered knowledgeable.

4.7. Data collection procedures

4.7.1. Data collection instrument

A data collection tool for the patient interview was developed from previously conducted studies
(12). The main tool for data collection was a semi-structured, face-to-face interview using a
standardized questionnaire. The questionnaire was first developed in English and the translated
to Amharic, the local language, and finally retranslated to English to ensure uniformity of the
questionnaire. A brief questionnaire was used to record, self-report demographic details of the
participants (such as age, sex, educational levels, occupational status, marital status, ethnicity,
facility setting and interaction factors with pharmacy service providers) and dosing instruction
understandings. As a result, the tool was divided into two sections: the first piece covered socio-
demographic and patient-dispenser characteristics, while the second component addressed
patients' understanding of the medication(s) dispensed to them at the hospital pharmacy's exit
(34,14). The questionnaire was based in part on the WHO's Management Science for Health
document and the Ethiopian Food, Medicine, and Healthcare Administration and Control
Authority's good dispensing practices standards. All the steps in designing the questionnaire such
as: contents, formulating, sequencing, formatting, and translating the questions were followed.

19
4.7.2. Data collection methods

Data was collected by interviewing patients on exit from the outpatient pharmacy by using a
semi-structured interview questionnaire. Patients’ exit-knowledge indicates patients recall ability
about the pharmacists counseling and guidance on their dispensed medication at the exit of
outpatient pharmacy. To determine the exit-knowledge level, 12 questionnaires were developed.
The patient was assumed to be with sufficient knowledge about the dispensed medication when
he/she addressed two-thirds (≥8 out of 12) of the knowledge questionnaires.

4.7.2.1. Exit interviews

The exit interviews were conducted at a suitable place within the hospital premises, and away
from dispensary and other patients visiting the outpatient pharmacy. There were twelve items in
the section on patient knowledge (name of medicine, indication, dosage, frequency of
administration, route of administration, duration of treatment, possible adverse effect, any
interaction with other medicines or foods, storage condition of medicine and what to do if one or
dosage were missed, therapeutic outcome, and instructions ). If participants respond correctly to
each knowledge item, they were received 1 point; if they respond incorrectly, they received a
score of 0. When the medicine's name was pronounced correctly, it was regarded correct. When
the patient's response and the amount to be delivered at each time were similar, the dosage was
regarded correct (from the prescription). Other responses to knowledge questions was collected
and compared to the prescription in the same way.

4.7.3. Data collectors

Graduating pharmacy students who have a practical attachment at the outpatient pharmacy
during the data collection period were employed as data collectors.

4.8. Data processing and analysis

The collected data was compiled and checked for completeness. Then it was designated from 1
to 380 and written in consecutive order on the top of the questionnaire page. Next, the data was
entered into SPSS Version 26. Later, the data was cleared. SPSS Version 26 was used to analyze
the data, and the results were provided in tables and figures as needed. Chi-square test were
employed to look for any association between the dependent and independent variables with a

20
significance level (α) of 0.05. When p<0.05, it means that there is an evidence of association
between dependent and independent variables. Percent and frequency were the descriptive
statistics employed to summarize socio-demographic characteristics, the extent of interaction
between the pharmacists and patients, and the knowledge status of patients for the dispensed
drugs. The patient knowledge score of the dispensed drugs was calculated by assigning a score
to their recall of each questions. For each attribute a positive (yes) answer was assigned score of
1 and negative (no) answer assigned score of 0. Univariable and multivariable logistic regression
analyses was conducted to establish associations between patient marital status, patient
educational levels, perceived clarity of the pharmacist’s voice, and perceived simplicity of
instruction given to each patient by the pharmacist and the dependent variable (understanding of
dispensed drugs by the patient).

4.9. Data quality management and assurance

Before the actual data collection, the drafted interview tool was ultimately enhanced by pre-
testing on 5% of patients (19 patients) at dispensary unit of Polis Hospital which is found in the
same town. Following specific adjustments based on the pretest data, the data collection tool was
employed for the actual data gathering. Additionally, the completeness of the data was ensured
daily by the investigators to minimize a possible bias. Furthermore, the data collection was
carried out by four graduating pharmacy students who were well trained about the purpose and
method of data collection. The interview procedure was handled by the data collectors, who also
reviewed the replies immediately after each interview was completed. Consistency of the
questionnaire was maintained by translating English language into local language (Amharic
language) then back to English language. At every interview, each patient was well informed
about the goal of the study while simultaneously addressing the importance of replying to all the
inquiries sincerely as well. Finally, guideline on how to collect the data was developed.

4.10. Operational definition

Patient understanding: patient is assumed to be with sufficient understanding about the

dispensed medication when he/she addresses two-thirds (≥8 out of 12) of the knowledge
questionnaires.

21
4.11. Ethical considerations

Ethical clearance was obtained from the institutional review board of Universal Medical and
Business College, Research and Community Engagement Office (RCEO) for the purpose of data
collection. The support letter and clearance were then carried to the data collection area. Again, a
permission was granted from the study area. After approaching the study subjects, a sample of
them was selected and both the benefits and risks of the study were explained. Soon after, the
participants were requested for a verbal consent. The patient’s name and other identifications
were not written on the data collection tool for ensuring the confidentiality of the information
gathered.

4.12. Dissemination plan

The results of this study will be disseminated to all concerned bodies. A print copy and soft copy
of the research will be submitted to Universal Medical and Business College, department of
pharmacy. The final research paper will also be disseminated to TBGH.

22
5. RESULTS
5.1 Socio-demographic characteristics of the Respondents

In this study, 380 ambulatory patients were interviewed; more than half were females 201
(52.9%) and urban residents 369 (97.1%). The mean age of the respondents was 36 years (mean
± SD, ±12). According to Table 1, the majority of participants 266 (70%) fell within the age
range of 18 to 39. In terms of occupation, private employers made up the majority with 127
(33.4%), followed by government employers with 76(20%). Based on their level of education,
the majority 333 (87.6%) of the participants were literate.

23
Table 1 Socio-demographic characteristics of the patients at Tirunesh Beijing General
Hospital from May 09, 2022 to May 31, 2022, Addis Ababa, Ethiopia.

Ser No. Socio-demographic Frequency Percentage (%)

characteristics
1 Sex
Male 179 47.1
Female 201 52.9
2 Age category (years)
18-39 266 70
40-59 90 23.7
≥60 24 6.3
3 Religion
Orthodox 266 70
Muslim 63 16.6
Protestant 44 11.6
Other* 7 1.8
4 Marital status
Single 102 26.8
Married 270 71.1
Divorced/widowed 8 2.1
5 Educational status
Literate (can read and write) 333 87.6
Illiterate 47 12.4
6 Residence
Urban 369 97.1
Rural 11 2.9
7 Occupation
Government employee 76 20
Private employee 127 33.4
Student 19 5
Pensioner 18 4.7
Unemployed 71 18.7
Other** 69 18.2
8 Income per month (Birr)
<724 157 41.3
≥724 223 58.7
th
Note: Other* stands for catholic, 7 day Adventist and Joba. Others** stands for laborer,
farmers and other minor (in terms total % based on the collected data) work groups.

24
5.2 Pharmacy service provision and interaction characteristics of respondents

More than half of the participants (170, 44.7%) reported returning to the pharmacy three times or
more, and more than three-quarters (326, 85.8%) said they had positive interactions with the
pharmacist. Amharic was used as the main language of exchange with the pharmacist (330,
86.8%). Additionally, practically all of them (357, 93.9%) stated that the pharmacy staff
members' voices and tones were audible. Almost all of the respondents (307, 80.8%) rated the
waiting area's cleanliness and comfort as comfortable, as stated in Table 2. Also, more than half
of the participants (324, 87.9%%) said the pharmacy service provider was polite, and more than
half of the participants felt that the information provided by the dispenser was enough (353,
92.9%).

25
Table 2 Pharmacy service provision and interaction characteristics of respondents at
Tirunesh Beijing General Hospitals’ outpatient pharmacy from May 09, 2022 to May 31,
2022, Addis Ababa, Ethiopia.

Ser No. Characteristics Frequency Percentage

(%)
1 Pharmacy visit frequency
First time 146 38.4
Second time 64 16.8
Repeated times 170 44.7

2 Perceived interaction status with pharmacist rated

by patient
Poor 20 5.3
Moderate 34 8.9
Good 326 85.8

3 Primary language communicated by patient

Amharic 330 86.8
Afan Oromo 42 11.1
Tigrigna 4 1.1
Other* 4 1.1

4 Perceived clearness of pharmacist’s voice and tone

Clear 357 93.9
Not clear 23 6.1

5 Perceived comfort of waiting area

Very comfortable 24 6.3
Comfortable 307 80.8
Uncomfortable 26 6.8
Neutral 23 6.1

26
 6 Perceived politeness of service provider
Very polite 22 5.8
Polite 324 87.9
Impolite 19 5
Neural 5 1.3

7 Perceived sufficiency and clarity of dispensers

knowledge
Enough 353 92.9
Not enough 23 6.1
Do not know 4 1.1

Note: Other* refers to the Siltigna, Sidamigna, and other linguistic minorities.

5.3 Patient Understanding of Dispensed Drugs

Table 3 provides a summary of the knowledge status of the patients who were interviewed as
they left the TBGH outpatient pharmacy. The majority of patients recalled the following details
about their dispensed medication: visual identification of the medication (89.5%), medication
indication (86.6%), route of administration (95%) and frequency (94.2%), proper handling of the
received drug (73.9%), duration of therapy (80.5%), expected therapeutic outcome (86.8%), and
labels and usage instructions (51.3%). Overall, just 147 (38.7%) patients had sufficient
knowledge of the drugs that had been prescribed to them.

27
Table 3 Patients’ understanding of their dispensed medication at the outpatient pharmacy
of Tirunesh Beijing General Hospital from May 09, 2022 to May 31, 2022, Addis Ababa,
Ethiopia.

Ser No. Patient’s understanding status Frequency (%)

1 Name(s) of the medication(s)
Yes 49 (12.9)
No 331 (87.1)
2 Visual identification of the medication(s)
Yes 340 (89.5)
No 40 (10.5)
3 Medication indication
Yes 329 (86.6)
No 51 (13.4)
4 Route of administration
Yes 361 (95)
No 19 (5)
5 Medications frequency
Yes 358 (94.2)
No 22 (5.8)
6 Drug interaction
Yes 11 (2.9)
No 369 (97.1)
7 Possible side effect of the medication
Yes 27 (7.1)
No 353 (92.9)
8 Appropriate handling of the received drug
Yes 281 (73.9)
No 99 (26.1)
9 Duration of therapy
Yes 306 (80.5)
No 74 (19.5)
10 Action taken for forgotten dosage
Yes 83 (21.8)
No 297 (78.2)
11 Expected therapeutic outcome
Yes 330 (86.8)
No 50 (13.2)
12 Labels and instructions on how to use the medication
Yes 195 (51.3)
No 185 (48.7)
13 Overall knowledge status (knowledge sufficiency)
Sufficient knowledge (≥8 positive responses) 147 (38.7)
Not sufficient knowledge (˂8 positive responses) 233 (61.3)

28
5.3.1 Overall knowledge score
The average knowledge score was found to be 7.02 which represent 58.5% of the total score.
Most patients had a score of 7.

Table 4: Patient knowledge scores for dispensed drugs at the outpatient pharmacy of
Tirunesh Beijing General Hospital from May 09, 2022 to May 31, 2022, Addis Ababa,
Ethiopia.

Patient knowledge score (out of 12) Frequency (%) Average knowledge score
3 2 (0.5)
4 18 ( 4.7)
5 39 (10.3)
6 72 ( 18.9) 7.02
7 102 (26.8)
8 92 (24.2)
9 42 (11.1)
10 8 (2.1)
11 4 (1.1)
12 1 (0.3)

5. 4 Factors affecting patient understanding of dispensed drugs

To determine the factors affecting patients' understanding of the medications they were
prescribed, regression studies were carried out. The outcomes of the multivariable regression
analysis showed that there were positive relationships between a number of different variables
and patient understanding of the medications they were prescribed (Table 5). Among the socio-
demographic characteristics of the participants’ educational status of the participants
significantly affects their recall potential about their dispensed medication. Patients who are
illiterate had 0.26 times sufficient knowledge than those of literate (95% CI: 0.116-0.582).
Participants who visited the pharmacy repeated times were found 1.913 times more likely to
have sufficient knowledge in comparison to those who visited only once (95% CI: 1.177-3.108).
Also, the odds of sufficient exit-knowledge was 0.138 (95% CI: 0.032‒0.599) and 0.484 (95%
CI: 0.050 ‒4.697) times lower in those who responded “I got not enough information from the

29
 pharmacist” and “neutral”, in comparison to those who responded “I got enough information
from the pharmacist”, respectively.

Table 5 Regression analysis for factors affecting patients’ understanding of their dispensed
drugs at the outpatient pharmacy of Tirunesh Beijing General Hospital from May 09, 2022
to May 31, 2022, Addis Ababa, Ethiopia.

Variables Sufficient knowledge COR(95% CI) AOR (95% CI) P-

values
Yes No
N (%) N (%)
Education status
Literate 139 194 (58.3) 1 1
Illiterate (41.7) 39 (83) 0.286 (0.130-0.632) 0.26(0.116-0.582) 0.001
8 (17)
Frequency of visit
First time 46 (31.3) 100 (42.92) 1
Second time 25 ( 17) 39 (16.74) 1.394 (0.756-2.569) 1.225(0.646-2.323) 0.534
Repeated time(three times and above ) 76 (51.7) 94 (40.34) 1.758 ( 1.107-2.789) 1.913(1.177-3.108) 0.009

Perceived sufficiency and clarity of

dispensers knowledge
Enough 144 209 (89.7) 1 1

Not enough (97.96) 21 (9.01) 0.138 (0.032-0.599) 0.106(0.024-0.471) 0.003

Neutral 2 (1.36) 3 (1.29) 0.484 (0.050-4.697) 0.813(0.067-9.798) 0.871

1 (0.68)

30
6. DISCUSSION

The patients’ knowledge of dispensed drugs is one of the essential prerequisites for patient
compliance with the treatment. Our cross-sectional study explores patients understanding and
factors affecting patients’ exit-knowledge about their dispensed medication in the outpatient
pharmacy of AGH. The exit-knowledge of the patients was affected by different factors includes
socio-demographic characteristics and perception of the patients and healthcare-related factors.

One of the key components of the rational use of the drug is informing the patient about their
medical conditions and pharmacological therapy. Patients should be informed and educated
about their pharmacological therapy for this reason. Poor adherence to prescribed prescriptions
and insufficient interaction between patients and pharmacists might result in treatment failure
(14). In this study, the majority of the patients believed that their interactions with the
pharmacists (85.8%), their clearness of voice and tone (93.9%), their politeness (87..9%), and the
pharmacists' knowledge sufficiency (92.9%) were sufficient to help them remember how to take
and use their medications. The result was comparable to that of other Ethiopian studies (8).

The results of this study showed that the majority of patients (92.9%) were unaware of the
possible side effects of the drug they were being administered. It's critical for people to be aware
of a medication's potential adverse effects so they can spot them early and notify doctors about
them right away. According to a study, patients had adequate adherence to their drug therapy and
received the right kind of medication-related information, including information on adverse
effects. According to a Canadian study, therapy is frequently discontinued as a result of negative
effects. A comparable study in Ethiopia from Mekelle (31.2%) and Harar (33.6%) found that
fewer patients are aware of the possible side effects of their medication. This may be due to the
patients' low levels of education, the pharmacist's heavy workload, and the uncomfortable
waiting space in the distribution room. Our study participant's less frequent (1) pharmacy visits
(38.4%) may be another good explanation. According to a Saudi Arabian study, patients who had
previously visited a pharmacy knew a great deal about the prescriptions they had been given
(14).

In this study, the majority of the patients (95%, 95.3%, 94.2%, and 86.8%) recalled the
prescribed drugs' route of administration, duration of therapy, frequency, and therapeutic

31
outcome, respectively. This illustrates how well the study participants remember their drugs
when they leave the pharmacy. Our results are generally consistent with a study carried out in
Ayder Comprehensive Specialized Hospital, Mekelle, which revealed that the majority of the
participants (95.3%, 92.5%, 94.5%, and 99.5%, respectively) remembered the route of
administration, duration of treatment, frequency, and therapeutic outcome of the dispensed
medications. Our findings also revealed that, just 12.9% of participants remembered the name
and what to do if a dose is missed (21.8%). But according to a study conducted in Hiwot Fana
Specialized University Hospital in Ethiopia, 46.4% of patients and 34.6% of patients,
respectively, recall the names and actions after a dosage is missed. This is almost four times
higher for the name than in our study.

Only 38.7% of the participants in the current study had sufficient exit information about the drug
they had been prescribed, according to the study's findings. This finding is lower than that of the
research done at Ambo General Hospital (55.5%) and Primary health care in the Brazilian
Healthcare System (41.8%) (16). However, it is higher than studies conducted in Gondar
(38.3%) (32), eastern Ethiopia (38.6%) (17) and a study from the rural Gambia (16.1%). The
findings from the various studies may not agree with one another because of several factors,
including patient education levels, language barriers, hesitation among patients in asking about
medicines due to fear of insult, insufficient education provided by healthcare professionals,
frequency of pharmacy visits, and discrepancies in how the knowledge score was calculated. Our
research showed that individuals who visited the outpatient pharmacy less than twice times had a
high probability of having insufficient exit-knowledge about the drug they had been given.
Similar research revealed that participants' inadequate exit knowledge was a result of the
language barrier between the pharmacist and the patients (32).

It was also discovered that the amount of patient education provided by the pharmacist affected
the likelihood that patients would learn enough about the medications they were prescribed.
Patients who thought the pharmacist’s sufficiency and clarity of knowledge was not enough
(AOR: 0.106; 95% CI: 0.024-0.471), and neutral (AOR: 0.813; 95% CI: 0.067-9.798) had
considerably less knowledge than those who thought it was enough. Furthermore, to accomplish
distinctive improvements for the benefit of patients, effective communication between the
pharmacist and other healthcare professionals is crucial. In general, practitioners work with

32
patients to improve their health, and the effectiveness of this collaboration depends on their
ability to communicate in a way that encourages the patient to engage in healthy habits.
Additionally, numerous studies show how crucial it is for pharmacists to engage in ongoing
patient counseling in order to greatly increase patients' drug understanding and adherence (s).
Therefore, it is not surprising that these study results show that a pharmacist can positively affect
the patient's exit knowledge for their prescribed medication by interacting with the patient and
providing clear, sufficient instruction about the medication.

7. STRENGTH AND LIMITATION

7.1 Strength

 Questioners were pre-tested to assure the quality of the questions which will contribute to
the quality of the finding.

 The study has highlighted information with regard to potential factors which may affect
Patients understanding of their dispensed drugs. This type of data may be used as a
baseline reference for those working the area of dispensing units and those who want to
conduct further research on the topic.

 The sample's representativeness is guaranteed.

 A cross-sectional study was which is best in determining prevalence and relatively quick.

 Going to the Tirunesh Beijing General Hospital, asking patients questions, and having
direct conversations with them about the medications they were taking and the factors
that affected their understanding allowed the data collector to complete his task and show
the study's applicability at the time it was conducted. reliability and adaptability.

7.2 Limitations

 This study had some possible weaknesses. The authors made an effort to assess the status
of ambulatory patients' pharmacological knowledge. However, the level of knowledge at
exit was significantly dependent on each patient's capacity for information recall and
retention. The subjective character of the data could cause the knowledge measurement to

33
 be underestimated. Since the number of drugs dispensed to patients was believed to have
an impact on their ability to retain information about the drugs, this measurement only
took into account patients who received less than or equal to three medications from the
outpatient pharmacy to evaluate the exit knowledge of the ambulatory patients.
 This type of study design can only be used to ascertain prevalence because it cannot
establish the sequence order of events (temporal relationship).
 In addition to these limitations, patients were only considered knowledgeable about the
drugs they were prescribed if they correctly answered at least two-thirds of the
knowledge questions. As a result, the knowledge status at exit may have been
underestimated. Future research examining the patients' long-term memory and
knowledge with their drugs may be necessary. Therefore, any interpretation of the study's
conclusions should take the aforementioned limitations into account.

8. CONCLUSION AND RECOMMENDATION

8.1 Conclusions

The present study found that less than half of the patients met the defined criteria for adequate
exit knowledge and a number of factors related to patient and dispenser-related the exit
knowledge of patients on how to use dispensed drugs. Patients' awareness of their prescribed
medications has been impacted by their lack of education, frequent visits to the outpatient
pharmacy, and their perception of the clarity and sufficiency of the information given.

8.2 Recommendations

 Dispensers should take extra care with those individuals who have low educational
levels.
 The community's educational standards should be raised by undergoing public educations
to the whole community by health professionals, and pharmacists should receive better
communication skills and trainings for the just implemented new dispensary system. This
will probably improve the patient-pharmacist relationship and the patients'
comprehension of the drugs they are receiving.

34
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20. Umira S et al. Assessment of patient’s knowledge regarding dispensed medication in a South
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MaxZ~X6WQRXWxzAtsac6QoRGIDfXDKZGZibqF4uVm1R9YJNbkKZNXDhX1VrHeX3Izv
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22. Romero J et al. Prevalence and predictors of inadequate patient medication knowledge.
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23. Fredericksen R et al. Medication understanding among patients living with multiple chronic
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24. Corre L et al. Assessment of patient understanding of their medicines: interviews with
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drug dispensing: A case study from a tertiary hospital in Ethiopia. Open Journal of Preventive
Medicine. 2014 Jan 8;2014. Accessible at: https://www.scirp.org/html/1-1340202_41723.htm

30. Mekonen S et al. Importance of labelling and patient knowledge to ensure proper care during
drug dispensing: A case study from a tertiary hospital in Ethiopia. Open Journal of Preventive
Medicine. 2014 Jan 8;2014. Available at: https://www.scirp.org/html/1-1340202_41723.htm

31. Terefe A, Chanie T. Assessment of patients misunderstanding of dosage regimen instructions

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33. Diriba G et al. Assessment of patients misunderstanding regarding dosage regimen

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10. Annexes

Part I. Participant information sheet and information consent form

Dear respondents, we are 5th year graduating pharmacy students and we came from universal
medical and Business College (UMBC). We are here to collect data for research that will help us
finish our research for a pharmacy degree at UMBC.

Title of the study: Patient understanding of dispensed drug and factors affecting it as a patient
care indicator at TBGH outpatient pharmacy in Addis Ababa, Ethiopia, 2022.

Objective: To assess patient understanding of dispensed drugs and factors affecting it at TBGH
outpatient pharmacy in Addis Ababa, Ethiopia, 2022.

Procedure and duration: We've chosen you using a probability systematic random sampling
approach, and we'd like to invite you to participate in the study. As a patient care indicator, your
participation will help us analyze patients' understanding of administered medications and factors
impacting it. We're going to ask you some questions regarding how well you understand your
medicine. Your sincere response will be beneficial to our research. As a result, we respectfully
request that you allow us this time for the interview. We shall express our gratitude for your
assistance in answering these questions.

Risk and benefit: This study has no risk, and all you have to do is set up some time for an
interview. There would be no payment for taking part in this study. However, the findings of this
study might provide crucial information to the relevant bodies.

Confidentiality and privacy statement: Any personal information will be kept confidential. There
will be no data that might be used to identify a specific individual. The findings of the study will
be general for the study population and will not represent anything specific to any one person.
The questionnaire will be coded so that no one's name will appear.

Right: This study's participation will be entirely voluntary. You have the option of participating
in this study or not. You have the right to withdraw from the study at any time if you decide not
to participate, and this will not result in any loss of benefits to which you are otherwise entitled.

41
Do you agree to participate in this study?

Yes:________________ No: _________________

Signature of respondent:_________________________

Signature of interviewer:_________________________

Contact address : if there is any question or enquire about the study or procedure , please
contact by this address any time:

 Cell +251923289781
 Email- [email protected]

42
Part II.

1. Questionnaire A. Variables affecting patient knowledge of dispensed drugs

Table 1 Socio-demographic and behavioral characteristics of patients at TBGH

outpatient pharmacy, May 2022.

S.N. Question Response

1. Age in year ____________(in year)
2. Sex A. Male
B. Female
3. Religion A. Orthodox
B. Muslim
C. Protestant
D. Others
4. Marital status A. Single
B. Married
C. Divorced
E. Widowed
5. Educational status A. Literate (can read and write)
B. Illiterate (can’t read and write)

6. Place of residence A. Urban

B. Rural
7. Occupation A. Government employee
B. Private employee
C. Student
D. Pensioner
E. Unemployed
E. Others (specify)
8. Estimated average income
_______________Birr.

43
Table 2 Pharmacy service provision and interaction characteristics of Patients at TBGH
outpatient pharmacy, May 2022.

S.N. Question Response

1. Frequency of visit to the pharmacy? A. First time
B. Second time
C. Repeated times( three times and above)
2. Interaction with pharmacist? A. Poor
B. Moderate
C. Good
3. Primary language of communication? A. Amharic
B. Afan Oromo
C. Tigrigna
D. Others
4. Voice and tone of the pharmacy A. Clear
personnel? B. Not clear

5. Comfort and cleanness of the waiting A. Very comfortable

areas? B. Confortable
C. Uncomfortable
D. Neutral
6. Politeness and interest of pharmacy A. Very polite
service provider? B. Polite
C. Impolite
D. Neutral
7. Perceived sufficiency and clarity of A. Enough
dispensers’ information and B. Not enough
instructions on how to take C. I don’t know
medication?

44
B. Patient knowledge of dispensed drugs

1. Do you know the name(s) of your medicine(s)?

Yes________, No________, Some/most________

If yes tell me the name(s), ______________________________

2. Can you visually identify all of your medicines?

Yes_________, No__________ Recognition of color or size only____________

3. Do you know the reason why this drug is prescribed for you?
Yes________ No_________, if yes: why is that? ___________
4. Do you know how to administer your medication?
Yes_________ No________, if yes: how? _______________
5. How often do you take your drug(s) per day?
A. Once E. where ever it is needed
B. Twice F. I don’t know
C. Three times G .Others__________________
D. Four times
6. Do you know how much drug is taken at once (dose)?
Yes___ No_____, if yes how much________
7. Are you aware of any possible side effects from your medication?

Aware___________, Unaware_____________

8. Where do you keep your medication at home?

A. Inside the box D. In open Room

B. In refrigerator E. Others__________________
C. In a locked cabinet
9. How long will you be taking the medication?
A. For _________day(s)
B. I don’t know
C. Until the symptoms are resolved

45
D. Others___________________________
10. Do you know what to do if you miss a dose?
Yes_________________ No________________
If yes, what will you do_________________________________________
11. Do you know what your medicine's expected therapeutic effect is?
Yes_________ No__________
12. Do you understand the labels and instructions on your medicine (s)?
Yes__________ No__________

46
8. ዕዝሎች

ክፍል I. የተሳታፊዎች መረጃ ቅጽ እና በመረጃ የተደገፈ የስምምነት ፎርም

ውድ መልስ ሰጭዎች፣ እኛ የ5ኛ ዓመት የፋርማሲ ዕጩ ምሩቅ ተማሪዎችን ስንሆን የመጣነው ከዩኒቨርሳል
ሜዲካል እና ቢዝነስ ኮሌጅ (UMBC) ነው። እዚህ የተገኘነው በዩኒቨርሳል ሜዲካል እና ቢዝነስ ኮሌጅ የፋርማሲ
ዲግሪ የምናከናውነውን የምርምር ሥራችንን ለመፈጸም የሚረዳንን የምርምር መረጃ ለመሰብሰብ ነው።

የጥናቱ ርዕስ: በጥሩነሽ ቤጂንግ ሆስፒታል የተመላላሽ ታካሚ ፋርማሲ ውስጥ በአዲስ አበባ፣ ኢትዮጵያ፣ 2014
በታካሚ ክብካቤ ጠቋሚነት የሥራ መደብ ላይ የተሸጡ መድሃኒቶችን በተመለከተ እና በዚሁ ላይ ተፅዕኖ
የሚያሳድሩ ምክንያቶችን በተመለከተ የታካሚው ግንዛቤ፡፡

የጥናቱ ዓላማ: በጥሩነሽ ቤጂንግ ሆስፒታል የተመላላሽ ታካሚ ፋርማሲ ውስጥ በአዲስ አበባ፣ ኢትዮጵያ፣ 2014
የተሸጡ መድሃኒቶችን በተመለከተ እና በዚሁ ላይ ተፅዕኖ የሚያሳድሩ ምክንያቶችን በተመለከተ ታካሚው
የሚኖረውን ግንዛቤ መገምገም፡፡

የጥናቱ ክንዋኔ እና ቆይታ፡- ፕሮባቢሊቲ ሲስተማቲክ ራንደም ሳምፕሊንግ የተሰኘውን በጊዜ ልዩነት በዘፈቀደ
ከጠቅላላ ስብስብ ውስጥ ናሙና የሚመረጥበትን አቀራረብ በመጠቀም እርስዎን መርጠንዎታል እና በጥናቱ ላይ
እንዲሳተፉ ልንጋብዝዎ እንወዳለን። እንደ ታካሚ እንክብካቤ ጠቋሚ፣ የእርስዎ ተሳትፎ የሚሆነው የታካሚዎችን
የተሰጡ መድኃኒቶችን እና በእነርሱ ላይ ተጽእኖ የሚያሳድሩትን ነገሮች ግንዛቤ ለመተንተን ይረዳናል፡፡
መድሃኒትዎን ምን ያህል እንደተረዱት ለማወቅ አንዳንድ ጥያቄዎችን እንጠይቅዎታለን። የእርስዎ ቅን ምላሽ
ለጥናታችን ጠቃሚ ይሆናል። በመሆኑም ለቃለ ምልልሱ ይህን ጊዜዎን እንድትሰጡን በአክብሮት እንጠይቃለን።
ለእነዚህ ጥያቄዎች መልስ በመስጠት ስላደረጉልን ድጋፍ እናመሰግናለን።

አደጋ እና ጥቅም: ይህ ጥናት ምንም ጉዳት የለውም እና እርስዎ ማድረግ የሚጠበቅብዎት ለቃለ መጠይቅ
የተወሰነ ጊዜ መስጠት ብቻ ነው፡፡ በዚህ ጥናት ውስጥ መሳተፍ ምንም ክፍያ አይኖረውም፡፡ ይሁን እንጂ የዚህ
ጥናት ግኝቶች፣ ለሚመለከታቸው አካላት ወሳኝ መረጃ ሊሰጥ ይችላል።

ሚስጥራዊነት እና የግላዊነት መግለጫ፡ ማንኛውም የግል መረጃ በሚስጥር ይጠበቃል። አንድን የተወሰነ ግለሰብ
ለመለየት ጥቅም ላይ ሊውል የሚችል ምንም መረጃ አይኖርም። የጥናቱ ግኝቶች፣ ለጥናቱ አጠቃላይ ወሰን
አንደጠቅላላ የሚያገለግል ይሆናል እና ለአንድ ሰው የተለየን ነገር አይወክልም። መጠይቁ፣ የማንም ስም
እንዳይገለጥ ኮድ ይደረጋል።

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መብ: በዚህ ጥናት ላይ የሚደረግ ተሳትፎ ሙሉ በሙሉ በፈቃደኝነት ይሆናል፡፡ በዚህ ጥናት ውስጥ የመሳተፍ
ወይም ያለመሳተፍ ምርጫ አለዎት። ላለመሳተፍ ከወሰኑ በማንኛውም ጊዜ ከጥናቱ የመውጣት መብት አለዎት
እና ይህ በሌላ መልኩ ሊያገኙ የሚችሉትን ጥቅማጥቅሞች አያሳጣዎትም።

መብቶች: በዚህ መረጃ አሰባሰብ ውስጥ የሚካፈሉት ግለሰቦች ሙሉ ለሙሉ በራሳቸው ፍቃድ የተስማሙ ናቸው፡፡
ግለሰቦች መጠይቁ ላይ ለመሳተፍም ሆነ ላለመሳተፍ ሙሉ መብት አላቸው፡፡ በጽሁፉ ለመሳተፍ የወሰኑ ግለሰቦችም
በማንኛውም ሰዓት ተሳትፎዋቸውን ማቋረጥ የሚችሉና ያለመቀጠል ሙሉ መብት ያላቸው ሲሆን ይኼም
ድርጊታቸው በማንኛውም አይነት ነገር እንደማያስጠይቃቸው እና መጠይቁን ሲጀምሩ ቃል የተገቡላቸው
ጥቅማጥቅሞች ከነበሩ እንደማያስቀሩባቸው ከወዲሁ እናስታውቃን፡፡

በዚህ ጥናት ለመሳተፍ ተስማምተዋል?

አዎን :_ _______________ የለም:_________________

የመልስ ሰጪው ፊርማ ፡_ ________________________

የጠያቂው ፊርማ ፡_ ________________________

የግንኙነት አድራሻ: ስለ ጥናቱ ወይም ሂደቱ ማንኛውም ጥያቄ ወይም አስተያየት ካለዎት እባክዎን በማንኛውም
ጊዜ በዚህ አድራሻ ያግኙን፡-

 ስልክ +251923289781
 ኢሜል- [email protected]

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ክፍል ሁለት

1. መጠይቅ

ሠንጠረዥ 1 በጥሩነሽ ቤጂንግ ሆስፒታል የተመላላሽ ታካሚ ፋርማሲ የታካሚዎች ማሃበራዊ እና ስነህዝብ መረጃ
እና ባሕሪያዊ ጠባዮች መጠይቅ ግንቦት፣2014 ዓ.ም

ተራ.ቁ. ጥያቄ ምላሽ

1. ዕድሜ በዓመታት ____________ (በዓመት)

2. ጾታ ሀ. ወንድ
ለ. ሴት
3. ሃይማኖት ሀ.ኦርቶዶክስ
ለ.ሙስሊም
ሐ.ፕሮቴስታንት
መ. ካቶሊክ
ሠ. ሌሎች
4. የጋብቻ ሁኔታ ሀ.ያላገባ/ች
ለ.ያገባ(ች)/የተፋታ(ች) ወይም ባል/ሚስት የሞተባት/በት

5. የትምህርት ደረጃ ሀ. የተማረ (ማንበብ እና መጻፍ የሚችል)

ለ. ያልተማረ (ማንበብና መጻፍ የማይችል)
6. የመኖሪያ ቦታ ሀ. ከተማ
ለ. ገጠር
ሐ. ከከተማ አቅራቢያ

7. ሥራ ሀ. የመንግስት ሰራተኛ
ለ. የግል ሰራተኛ
ሐ. ተማሪ
መ.ጡረተኛ
ሠ. ስራ የሌለው
ረ. ሌሎች (ይግለጹ)

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8. ወርሃዊ ገቢ(ደመዎዝ)
_______________ብር

ሠንጠረዥ 2 በጥሩነሽ ቤጂንግ ሆስፒታል የተመላላሽ ታካሚ ፋርማሲ የታካሚዎች የፋርማሲ አገልግሎት አቅርቦት
ግንቦት፣2014 ዓ.ም

ተራ ቁ. ጥያቄ ምላሽ
1. ወደ ፋርማሲው በምን ያህል ድግግሞሽ ሀ. ለመጀመሪያ ጊዜ
ይመጣሉ? ለ ሁለተኛ ጊዜ
ሐ. ተደጋጋሚ ጊዜያት (ሦስት ጊዜ እና ከዚያ በላይ)
2. ከፋርማሲስት ጋር ያለው መስተጋብር ምን ሀ. መጥፎ
ይመስላል? ለ. መካከለኛ
ሐ. ጥሩ

3. ዋና የመግባቢያ ቋንቋዎ ምንድን ነው? አ.አማርኛ

ብ አፋን ኦሮሞ
ሐ. ትግርኛ
መ. ሌሎች
4. የፋርማሲው ሰራተኞች ድምጸት እና የድምጽ ሀ. ይሰማል
እርጋታ ደረጃ? ለ. አይሰማም

5. በፋርማሲው ውስጥ ያሉ የመጠበቂያ ሀ. በጣም ምቹ

ቦታዎች ምቾት እና ንፅህና? ለ. የማይመች
ሐ. ገለልተኛ
መ. ምቹ
6. የፋርማሲ አገልግሎት አቅራቢ ትህትና እና ሀ. በጣም ትሁት

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 ፍላጎት? ለ. ትሁት
ሐ. ትሁት ያልሆነ
መ. ገለልተኛ
7. በቂ እና ግልጽ የአከፋፋዮች መረጃ እና ሀ. በቂ
መድሃኒት እንዴት እንደሚወስዱ ለ. በቂ አይደለም
መመሪያዎችን ተረድተዋል? ሐ. አላውቅም

2.ታካሚዎች ስለ ታለተሸጡላቸው መድሀኒቶች ያላቸዉ እዉቀት

1. የመድኃኒትዎን ስም(ዎች) ያውቃሉ?

አዎ________፣ አይ________፣ ጥቂቶች/አብዛኞቹ________

አዎ ከሆነ ስማቸውን ንገሩኝ፣ ________________________________

2. ሁሉንም መድሃኒቶችዎን በእይታ መለየት ይችላሉ?

አዎ __________፣ አይ__________ የቀለም ወይም የመጠን ብቻ እውቅና ____________

3. ይህ መድሃኒት ለእርስዎ የታዘዘበትን ምክንያት ያውቃሉ?

አዎ________ አይ________፣ አዎ ከሆነ፡ ለምንድነው? _____
4. መድሃኒትዎን እንዴት እንደሚውስዱ ያውቃሉ?
አዎ________ አይ________፣ አዎ ከሆነ፡ እንዴት? _______________
5. መድሀኒትዎን በቀን ስንት ጊዜ ይወስዳሉ?
ሀ. አንድ ጊዜ መ.መቼም አስፈላጊ ነዉ
ለ. ሁለት ጊዜ ሠ. አላውቅም
ሐ. ሦስት ጊዜ ረ .ሌሎች__________________
መ. አራት ጊዜ
6. የሚወስዷቸው መድሃኒቶች መካከል ያለውን ግንኙነት ይገነዘባሉ?

አዎ___ አይ_____ ፣

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አዎ ከሆነ ምን ያህል________

7. ከመድሃኒትዎ ጋር ተያይዘው ሊከሰቱ የሚችሉ የጎንዮሽ ጉዳቶችን ያውቃሉ?

አዎ __________፣ አይ _____________

8. መድሃኒትዎን በቤት ውስጥ የት ነው የሚያኖሩት?

ሀ . በሳጥን ውስጥ መ. በክፍት ክፍል ውስጥ

ለ. በማቀዝቀዣ ውስጥ ሠ. ሌሎች__________________
ሐ. በተቆለፈ ካቢኔት ውስጥ
9. መድሃኒቱን ለምን ያህል ጊዜ ይወስዳሉ?
ሀ. ለ_________ ቀን
ለ. አላውቅም
ሐ. ምልክቶቹ እስኪጠፉ ድረስ
መ. ሌሎች________________________
10. መድሃኒትዎን ሳይወስዱ ከረሱ ምን ማድረግ እንዳለቦት ያውቃሉ?
አዎ___________ አይ________________
አዎ ከሆነ፣ ምን ያደርጋሉ __________________________________________________
11. ከመድሃኒትዎ የሚጠበቀው የሕክምና ውጤት ምን እንደሆነ ያውቃሉ?
አዎ_____________ አይ__________
12. በመድሃኒትዎ ላይ ያሉትን ምልክቶች እና መመሪያዎች ተረድተዋል?
አዎ_______________ አይ__________

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