Management of asthma at private pharmacies in India.

SETTING

Chennai, India.

OBJECTIVE

To examine the medications and advice that retail pharmacy attendants recommend to customers presenting with typical symptoms of asthma in an urban area of India.

DESIGN

Four simulated clients described symptoms of mild persistent asthma to a quota sample of pharmacies in ten areas of the city. Clients recorded consultations with attendants and purchased a sample of the recommended medications.

RESULTS

A total of 52 shops were visited on 56 occasions. Shopkeepers offered 140 medications during the consultations, and clients purchased a sample of 100 medications (71%). Four shops (7%) refused to sell any medications. Attendants recommended oral bronchodilators during 26 (50%) consultations, antibiotics during 23 (44%), methylxanthines during 22 (42%) and oral corticosteroids during 20 (38%). No inhaled medications were ever recommended. The majority of the medications purchased were missing information about dosage (concentration), date of expiry and active ingredients. Thirteen (24%) of 54 attendants advised the clients to seek medical attention.

CONCLUSION

The majority of individuals presenting with asthma symptoms did not receive appropriate advice or medications from pharmacy attendants. Efforts to raise the quality of asthma management in developing countries should include interventions to improve pharmacy-guided self-medication.