1. 1 Household Survey on Medicine Use in Oman Ahmed Abdo-Rabbo, Manal Al- Ansari, Brian Gunn, Batool Suleiman & Hawraa Al-Lawati Directorate of Rational Use of Medicine Ministry of Health, Sultanate of Oman

2. 2 Introduction Irrational use & storage of medicines in the community:  Problem faced worldwide  Often forgotten & the most neglected target  Leads to medicine wastages & health risks  Needs much attention from all At public health facilities in Oman:  High availability & accessibility of medicines  Prescriptions dispensed free of charge It is the first household survey on medicine use in Oman

3. 3 Aims To investigate the chronic diseases of households To identify the type & use of traditional remedy used by households To know the available medicines at homes & their uses To know the channels of treatment & obtaining medicines To investigate the storage of medicines at homes To determine the left-over & expired medicines To evaluate the adequacy of labelling & patients ’ knowledge of correct dosage

4. 4 Methods A cross-sectional survey was conducted in 2009 Ethical clearance & authority permission were obtained A written pre-tested interview questionnaire was used along with direct observation The questionnaire covered the following aspects:  Characters & chronic diseases of households  Traditional remedy & modern medicines available & used in households  Channels of treatment & obtaining medicines  Storage conditions, left-over & expired medicines  Adequacy of labelling & patients ’ knowledge of correct dosage

5. 5 Methods (cont.) 2 districts 4 villages 2 urban (150) 2 rural (150) 2 districts 4 villages 2 urban (200) 2 rural (150) 1 district 2 villages 1 urban (100) 1 rural (100) 1 district 2 villages 1 urban (100) 1 rural (100)  Stratified sampling via aggregates ● 1050 households were interviewed ● 1050 households were interviewed  from 12 villages  from 12 villages  in 6 willayat (districts)  in 6 willayat (districts)  located in 4 regions  located in 4 regions (11 health regions in Oman) (11 health regions in Oman)  Inventory of the found medicines & answers were recorded & coded answers were recorded & coded individually individually  Data were processed & analyzed by SPSS / Excel analyzed by SPSS / Excel  The overall results reported as mean % or number mean % or number

6. 6 Results 1. Characters & chronic diseases of households %Parameter 98.00Omani families in the survey 50.19Parents in households with basic education 52.34Households represented urban community 44.39Households with chronic diseases 36.78Households with hypertension 31.54Households with diabetes mellitus

7. 7 2. Traditional remedy used by the households

8. 8 3. Medicines in the households 95% of families who had medicines at homes 6Average # of medicines found / household 45Maximum # of medicines found in a household 45.83% of households with antibiotics 12.55% of antibiotics from all medicines at homes 10Maximum # of antibiotics found in a household 51.66% of penicillins from all antibiotics at homes

9. 9 4. Most therapeutic classes of medicines in homes

10. 10 5. Channels of treatment & obtaining medicines 86.06%Medicines prescribed by physician 70.32%Medicines obtained from public pharmacy 21.11%Medicines obtained from private pharmacy 6. Adequacy of labelling & patients ’ knowledge of correct dosage 7.95%Percentage of medicines adequately labelled 65.86%Percent correct patient’s knowledge of dosage

11. 11 9. Storage places of medicines at homes

12. 12 10. Left-over & expired medicines at homes 61.31%Households keep left-over medicines 33.27%Households throw out left-over medicines 4.86%Households return medicines to pharmacy 31.64%Medicines at homes which were not in use 15.51%Respondents who do not check expiry date 67.26%Respondents who always check expiry date 97.64%Medicines in the households with expiry date 12.41%Medicines in the households already expired

13. 13 Conclusion Medicine use problems in households Unsafe use of traditional remedy Polypharmacy & therapeutic duplication Overuse / misuse of antibiotics Informal sources of treatment and channels of obtaining medication Self-medication with prescription medicines

14. 14 Conclusion (cont.) Medicine use problems in households (cont.) Inappropriate storage of medicines Abundance of unused, deteriorated or expired medicines Inadequate labeling Poor knowledge of correct dosage Lack of patient ’ s adherence to treatment

15. 15 Recommendations Medicine use assessment & a comprehensive evaluation are needed Realistic policies should be implemented & enforced Health providers & public education to increase their sensitization & awareness

16. 16