Quality of pharmacy services and regulatory compliance

A study by Syed Shaukat Muttaqi and colleagues on “Quality of Drug Stores, Storage practices and Regulatory compliance being published in this issue makes startling disclosures which are of course not unexpected. The investigators inspected one thousand three drug stores in Karachi excluding those located inside the Government run healthcare facilities and found that only 4.1%(41 drug stores) were compliant with the regulatory requirements. Only one hundred twenty four i.e. 12% had qualified persons working on the stores of which 33% were qualified pharmacists. Just four hundred drug stores had displayed drug sales licenses at the premises of which 282 had expired licenses which were not renewed. Ninety four of these stores were found to be selling vaccines without proper refrigerator and only 11.7% of these stores had the power backup for the refrigerator. Four hundred three stores were protected from the direct sunlight and just 54 which are 5.4% had air conditioning at the premises.1 If this is the state of affairs in a city like Karachi, what would be the situation in the smaller cities and towns is not difficult to imagine. Improper storage and transportation without cold chain results in decreasing the potency of these drugs and when these samples are picked up by the Drug Inspectors for quality control analysis, it is the drug manufacturers who are blamed for producing sub-standard drugs. There also seems to be no justification whatsoever in not getting the licenses renewed which also shows the poor performance of those entrusted with the task of ensuring compliance with the regulatory requirements. In most of the poor developing low and middle income couriers it is the private pharmacies, chemist shops which are considered as a valuable resource for providing health advice and medicines to the community. However, the quality of service they provide leaves much to be desired. Smith and colleagues reviewed the quality of private pharmacy services in low and middle income countries.2 This systematic review identified numerous deficiencies in the quality of professional practices. In particular they highlighted the non-availability of pharmacists or trained personnel working at these pharmacies. They were of the view that if the standard of pharmacy practice has to improve and pharmacists have to contribute effectively in healthcare, barriers to the provision of quality care and the ways through which these hindrances can be eliminated needs to be identified and examined. Another study on community pharmacy in Pakistan3 found that the average age of attendants at the pharmacy shops was between 21-30 years and only 9.49% of them have professional pharmacy education. They also concluded that at present the standard of community pharmacy was highly unsatisfactory. More pharmacists need to be involved at community pharmacy level besides developing awareness programmes to solve patient’s issues related to drugs to reduce the disease burden from the society. In the real world pharmacy in the developing low resource countries, private sector is dominant player in providing pharmacy services since Governments cannot afford to establish, man and run the drug stores all over the country for various reasons. This provision of drugs through Editorial