Availability of medicines in community pharmacy to manage patients with COVID-19 in Kenya; pilot study and implications

Multiple measures have been instigated across countries to prevent the spread and treat patients COVID-19 with personal protective equipment (PPE), sanitation measures and medicines. However, there has been considerable controversy surrounding initially endorsed treatments such as hydroxychloroquine with misinformation increasing prices and suicides. Prices of PPE and medicines have increased in countries following shortages, potentially catastrophic among lower- and middle-income countries (LMICs) with high co-payment levels. Consequently, there is a need to investigate changes in availability, utilisation, prices and shortages of relevant medicines during the pandemic in Kenya. To address this, a questionnaire was emailed to ten randomly selected community pharmacists from 21 purposely selected pharmacists attached to the University of Nairobi, with the survey covering the period from the start of the pandemic to the end of May 2020. This included suggestions from community pharmacists on potential ways forward with future pandemics. Six pharmacists eventually took in this pilot study. Two thirds noted increased requests for antimalarials and antibiotics; however, these were not dispensed with pharmacists recommending alternatives for symptomatic relief. There was increased use of analgesics as well as vitamins. Price rises were seen for hydroxychloroquine as well as vitamins and zinc (50-100% increase in price); however, no shortages were seen. The pharmacists believed their future role in pandemics include education, improved stock control and patient counselling. Overall, it was encouraging to see increases in the utilisation of vitamins/ immune boosters alongside no antimalarials or antibiotics dispensed without a prescription despite the hype and requests. Community pharmacists have a key role in any pandemic with prevention and guidance, and we will be monitoring this. Countries such as Kenya can also act as exemplar countries where there continues to be high rates of self-purchasing of antibiotics.