Do community pharmacists in Qatar manage acute respiratory conditions rationally? A simulated client study

Objectives: This study evaluated Qatar's community pharmacists’ therapeutic recommendations, medication labelling, dispensing and counselling practices in response to common cold and allergic rhinitis symptoms. Methods: A simulated client method was used to assess the practice behaviour of community pharmacists. Twenty-five pharmacies in Qatar were randomly selected and further randomised into two groups: common cold (n = 15) and allergic rhinitis (n = 10). The pharmacies were visited or called according to the study group twice by two independent simulated clients; each simulated client visited or called the 25 pharmacies once. Therapeutic recommendations, labelling, dispensing and counselling practices from the studied pharmacies were compared to Joint FIP/WHO (International Pharmaceutical Federation/World Health Organization) standard guidelines. Data analyses were performed using both descriptive and inferential statistics (α = 0.05). Key findings: Cough syrups (37%), analgesics (31%) and antihistamines (19%) were the most frequently dispensed medicines in the common cold scenario. Pharmacists were less likely to dispense cough syrups (12%) and analgesics (12%), but were more likely to dispense antihistamines (35%) in the allergic rhinitis scenario. Antibiotics were found in three encounters for each scenario. Many community pharmacists did not adhere to medicine labelling standard. No significant differences were found regarding labelling practices and important questions to be asked (P > 0.05), except questions related to fever and cough symptoms (P < 0.05). The median cost for treating allergic rhinitis was higher, but this did not reach statistical significance (QAR 60 versus QAR 51 (equivalent to USD 16.44 versus USD 13.97), P = 0.586). Furthermore, no significant differences were found between pharmacists’ gender (P = 0.642), pharmacy type (P = 0.487) and duration of encounter (P = 0.266). Conclusions: Community pharmacists in Qatar appeared to exhibit practices that are below the established standards in response to common cold and allergic rhinitis symptoms.