Access to essential psychotropic medicines in Addis Ababa: A cross-sectional study

Molla Teshager; Mesfin Araya; Teferi Gedif Fenta

doi:10.1371/journal.pone.0283348

Peer Review History

Original SubmissionJune 15, 2022
1 Sep 2022 Decision Letter - Andrea Cioffi, Editor PONE-D-22-17182Access to Essential Psychotropic Medicines in Addis Ababa: A Cross-Sectional StudyPLOS ONE Dear Dr. Fenta, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. The article has a correct structure, even the methodology used is suitable. I suggest you comply with the reviewers' comments; in addition, I suggest an English editing. Please submit your revised manuscript by Oct 16 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. 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We note you have included a table to which you do not refer in the text of your manuscript. Please ensure that you refer to Table 1 in your text; if accepted, production will need this reference to link the reader to the Table. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? 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Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: No Reviewer #2: No ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Dear authors, your research topic is very interesting and relevant. You have selected an appropriate methodology, but the methods section was not clearly described. Results presentation needs to be improved and made smarter maybe using figures. You have to avail the Excel worksheet in which you have entered data. You should also prepare supplementary files showing more details on prices and availability data. Reviewer #2: Commendable efforts have been laid down in this valuable research. With minor though multiple edits as mentioned in the comments in the attached file, the manuscript can be made into a more clear and useful document for access research. I hope the suggestions made will be looked into positively. Looking forward to seeing your revised manuscript. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Thomas Bizimana Reviewer #2: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. 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Attachments Attachment Submitted filename: Review comments - Access to Essential Psychotropic Medicines in Addis Ababa.docx Attachment Submitted filename: PONE-D-22-17182_reviewer report. pdf.pdf https://doi.org/10.1371/journal.pone.0283348.r001
Revision 1
24 Dec 2022 Author Response Access to Essential Psychotropic Medicines in Addis Ababa: A Cross-Sectional Study This Article is recommended for publication after improvement of the methods and results presentation sections. The study is scientifically relevant, the methodology employed is appropriate but not clearly described, and the way results are presented needs to be improved. A. Major comments I. General comments: 1. Carefully read the “Instructions for authors” concerning the format and how to cite references in the text. Ideally, use an automatic referencing system (e.g. Mendeley) and select the journal’s style. Response: EndNote referencing software with Vancouver referencing style was employed. II. References: 1. For all non-journal article references, provide the URL link and the date you lastly accessed it, to help reviewers check the correctness of the information. Response: Accommodated. III. Methods: 1. “1919 health facilities in Addis Ababa; of which 110 of them were public healthcare facilities and 558 were private retail pharmacies.” How about the other 1251 health facilities? Response: Out of the total 1919 health facilities, the 1251 health facilities were private clinics or hospitals, NGO clinics or hospitals and other retail pharmacies, which were not included in the sample as they were not within the scope of the study. 2. “The study population was 668 medicines retail outlets”. How did you move from 1919 to 668 health facilities? Response: The focus of the study was 110 public facilities’ dispensaries plus 558 private retail outlets making the study sample to be 668. 3. “The sample size was determined based on the WHO/HAI manual (29). Accordingly, 60 retail outlets; 30 each from the public and private sectors, were included.” Please, describe your methods clearly to help the readers understand what and how you have done. How did you come up with 60 from 1919 health facilities? Response: It is accommodated as suggested by the reviewers. 4. “Inclusion Criteria: Public health facilities that have outpatient pharmacies or dispensaries and private sector licensed retail pharmacies (closer to public health facilities) that are expected to stock psychotropic medicines were included in the study. Exclusion Criteria: Public Health facilities that only stock a small number of emergency psychotropic medicine; and pharmacies in private clinics and hospitals or health facilities operated by private companies, such as mining companies, were excluded. Furthermore, drug stores were excluded from the study.” Please, consult your teachers of research methodology to understand the meaning of exclusion criteria: you can’t take beans A and B from a basket, while beans A and B have not been in the basket! Correctly write this section. Response: accommodated. 5. “Thirty retail outlets for each sector were taken as an optimal sample size as per WHO’s recommendation.” Please, provide a reference with the URL link for this statement! Response: accommodated. 6. Table 2: why did you sample more health facilities from Bole sub-city more than from Kolfe and Addis Ketema (24/60)? Response: sample allocation was done based on proportionate to size technique. In private sector, Bole has the higher number of private medicine retail outlets (65) than (38) and Addis Ketema (38). B. Minor comments I. Entire manuscript: 1. The text lines should be numbered to ease the review with reference to the line numbers. Response: Accommodated II. Title page: 1. Author 1 and 2 have the same affiliation, use the same number “1”, then number 3 becomes number 2. Response: Accommodated III. Abstract: 1. Under the methods section, point out the types of health sectors surveyed. Response: Accommodated IV. Methods: 1. Rephrase the statement “An institution-based cross-sectional study was carried out between 30 July and 18 September 2019 using WHO/HAI tools to collect price and availability from public and private sectors in Addis Ababa, Ethiopia's capital city.” You have not collected prices and availability. Instead, you have collected data on prices and availability. Response: Accommodated 2. Keep 1 table Response: Accommodated V. Results: 1. “As shown in Figure 1, the availability of at least one essential psychotropic medicine from each therapeutic class was only observed only in six public medicine retail outlets, …”. Delete the repeated word “only”. Response: Accommodated 2. Some tables can be better replaced by figures. Response: We have been tried to replace tables by figures as suggested. However figures were not suitable for some because of large number of variables. So we prefer to keep the tables as it is. Attachments Attachment Submitted filename: Point by Point Response 2.docx https://doi.org/10.1371/journal.pone.0283348.r002
1 Feb 2023 Decision Letter - Andrea Cioffi, Editor PONE-D-22-17182R1Access to Essential Psychotropic Medicines in Addis Ababa: A Cross-Sectional StudyPLOS ONE Dear Dr. Fenta, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. The article still needs some minor revisions. Please submit your revised manuscript by Mar 18 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Andrea Cioffi Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: I Don't Know ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Few and minor edits before publication: 1. Cover page: Edit it according to the journal's template. Some information is not required. 2. Edit line 228 correctly. 3. Table 2 and 3: Remove medicines for which there are no data and describe them in the text. Delete "Table canted" and just make a summary. Data on prices should be provided for available medicines, otherwise they are meaningless. It is not clear why some medicines were available but no prices were recorded (e.g. chlorpromazine 100mg, haloperidol 2mg, ...). 4. Table 4 is misplaced. 5. Table 5: what is the meaning of absence of results on affordability? Provide an explanation in the text introducing this table. 6. Figure 1: No caption was inserted in the text. Results on availability should be expressed in terms of percentage. 7. References: URL missing for references No 2, 5, 20, 22, 23, 24, 46, 50, 51, and 55. A wrong URL was used for reference No 4, just copied from reference No 3. The URL for reference No 36 is not active. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Thomas Bizimana ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0283348.r003
Revision 2
4 Mar 2023 Author Response Point by point response to reviewers’ comments We are grateful to the reviewers for their constructive comments. Reviewer #1: Few and minor edits before publication 1. Cover page: Edit it according to the journal's template. Some information is not required. Response: comment accommodated. 2. Edit line 228 correctly. Response: accommodated 3. Table 2 and 3: Remove medicines for which there are no data and describe them in the text. Delete "Table contd." and just make a summary. Data on prices should be provided for available medicines, otherwise they are meaningless. It is not clear why some medicines were available but no prices were recorded (e.g. chlorpromazine 100mg, haloperidol 2mg,). Response: Table 3 is reformatted as suggested but we prefer to retain Table 2 as it indicates availability of the selected medicines. 4. Table 4 is misplaced. Response: accommodated 5. Table 5: what is the meaning of absence of results on affordability? Provide an explanation in the text introducing this table. Response: Affordability was determined only for medicines which are available in at least four retail-outlets in each sector during the survey time and price data is obtained from these outlets to have ameangful calculation of MPR. An explanation is included in the revised version. 6. Figure 1: No caption was inserted in the text. Results on availability should be expressed in terms of percentage. Response: Modified according to the suggestion 7. References: URL missing for references No 2, 5, 20, 22, 23, 24, 46, 50, 51, and 55. A wrong URL was used for reference No 4, just copied from reference No 3. The URL for reference No 36 is not active. Response: Reference carefully looked into and the following changes are made in the revised version: • No 2,5,20,22,23,24,46,50 and 55: URL included • No 51 new reference replaced • No 4 corrected • R36 is still active https://doi.org/10.1371/journal.pone.0283348.r004
7 Mar 2023 Decision Letter - Andrea Cioffi, Editor Access to Essential Psychotropic Medicines in Addis Ababa: A Cross-Sectional Study PONE-D-22-17182R2 Dear Dr. Fenta, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Andrea Cioffi Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0283348.r005
Formally Accepted
22 Mar 2023 Acceptance Letter - Andrea Cioffi, Editor PONE-D-22-17182R2 Access to Essential Psychotropic Medicines in Addis Ababa: A Cross-Sectional Study. Dear Dr. Fenta: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Andrea Cioffi Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0283348.r006

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