Behind the counter: Pharmacies and dispensing patterns of pharmacy attendants in Karachi

Background: There is little literature available on dispensing patterns and unsupervised sale of medicines from pharmacies in developing countries. Objective: This study obtained background information on pharmacies, assessed the level of training, knowledge and dispensing patterns of pharmacy attendants in Karachi. Methodolgy: This is a descriptive cross sectional study with convenient sampling. A structured questionnaire was used to interview pharmacy attendants. Results: Of the 219 pharmacies surveyed, 62% reported more than 50 customers daily and 20% also sold items of general provision. Mean operating hours were 13. Only 24 (11%) had a visible license. On an average 3 attendants were employed per pharmacy. We interviewed one in each. Amongst the 219 interviewed, 77 (35%) were intermediate qualified and only 26 (12%) pharmacologically trained. Correct frequency of ORS administration was not known by 167 (76%) and 21% incorrectly suggested an anti-diarrhoeal preparation for viral diarrhoea in children. The knowledge of those with pharmacological training was significantly better. For respiratory tract infection in children approximately 60% did not know the correct dose of Paracetamol and Amoxicillin. Only 13 (6%) knew that Propanalol was contraindicated in hypertensive asthamatics. For Co-trimoxazole, metronidazole and lomotil only 40%, 21% and 15% respectively, were aware that these could not be dispensed without prescription. Conclusion: In the absence of trained pharmacists existing pharmacy attendants should be trained to improve drug-dispensing patterns .