Quality of pharmacies in Pakistan: a cross-sectional survey

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