Quality of pharmacies in Pakistan: a cross-sectional survey

• Published in: International journal for quality in health care Vol. 17; no. 4; pp. 307 - 313
• Main Authors: Butt, Zahid A., Gilani, Anwar H., Nanan, Debra, Sheikh, Abdul L., White, Frank
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.08.2005; Oxford Publishing Limited (England)
• Subjects: Community Pharmacy Services - standards; Cross-Sectional Studies; drug sellers; Female; Humans; licensing requirements; Licensure - statistics & numerical data; Male; Medical service; Middle Aged; Pakistan; pharmacies; Pharmacies - standards; Pharmacists; Pharmacists - standards; Pakistan
• ISSN: 1353-4505; 1464-3677
• DOI: 10.1093/intqhc/mzi049

Objective. To estimate the proportion of pharmacies meeting licensing requirements and to identify factors associated with these pharmacies in urban Rawalpindi, Pakistan. Design. Cross-sectional questionnaire survey conducted during July–September 2001, of 311 pharmacies selected from a drug company list of 506. Setting. Free-standing licensed and unlicensed pharmacies in urban Rawalpindi. Study participants. A pharmacist or (if unavailable) the most experienced drug seller. Results. The proportion of pharmacies meeting licensing requirements was 19.3% [95% C.I (confidence interval): 15.1, 24.2], with few qualified persons (22%). Only 10% had a temperature-monitoring device and 4% an alternative power supply for refrigerators (present in 76% of pharmacies). Associated with pharmacies meeting licensing requirements was the knowledge of not giving co-trimoxazole, a prescription drug, without prescription [OR (odds ratio) = 2.0; 95% CI: 1.1, 3.6], knowledge of the temperature range for vaccines (OR = 2.6; 95% CI: 1.4, 4.8), availability of vaccines (OR = 2.8; 95% CI: 2.8, 18.4), and alternative power supply for the refrigerator (OR = 6.0; 95% CI: 1.5, 23.7). The practice of selling drugs without prescription was not found to have a significant association (OR = 1.1; 95% CI: 0.5, 2.3); however, it did show a trend indicating discrepancy between knowledge and practice. Conclusions. Most drug sellers had fragmentary knowledge regarding drug dispensing and storage, and improper dispensing practices. There is a need to enforce existing legislation with training programmes directed towards drug sellers and to involve the pharmaceutical industry, which plays an important role in influencing pharmacy knowledge and practices.