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Over the counter sale of MTP pills: Knowledge, Attitude and Practices of pharmacists in Delhi
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| Author:
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ISHA THAREJA, ARCHANA MISHRA, OISHIKA CHAKRABORTY
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| Abstract:
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Background: Medical abortion using a combination of mifepristone and misoprostol is a safe and effective method for termination of early pregnancy when used according to recommended guidelines. In India, abortion is legally permitted under the Medical Termination of Pregnancy (MTP) Act; however, over-the-counter (OTC) availability of medical abortion (MA) pills from pharmacies without prescription remains common. Pharmacies often serve as the first point of contact for women seeking abortion due to accessibility, anonymity, and convenience. This study aimed to assess the knowledge, attitudes, and practices (KAP) of pharmacists in Delhi regarding the OTC sale of MA drugs.
Methods: A cross-sectional study was conducted across 100 urban pharmacies in randomly selected districts of Delhi. Trained investigators administered a structured questionnaire assessing pharmacists’ knowledge of MA drugs, awareness of legal and clinical aspects of abortion, and dispensing practices. A knowledge score ranging from 0–10 was developed based on responses related to drug regimen, gestational limits, side effects, complications, and legal awareness. Participation was voluntary and confidentiality was ensured.
Results: Among the pharmacies approached, 70 participated in the study. While 92% reported the presence of a registered pharmacist, varying numbers of unqualified staff were also involved in dispensing medications. Approximately 23% of pharmacists reported dispensing MA drugs without a prescription, with some pharmacies indicating that up to 50% of MA drug purchases occurred without prescriptions. Knowledge assessment showed moderate awareness, with most participants scoring between 4 and 6 out of 10. Only a minority asked about gestational age (16 pharmacies) or pregnancy confirmation (18 pharmacies) before dispensing. Although all pharmacists explained the drug regimen to clients, none provided counselling on post-abortion contraception. A majority perceived OTC MA drug sales as hazardous and ethically problematic.
Conclusion: The study highlights significant gaps in pharmacists’ knowledge and counselling practices regarding medical abortion in Delhi, alongside continued OTC dispensing of MA drugs. Strengthening pharmacist training, improving regulatory enforcement, and integrating pharmacies into structured reproductive health frameworks may help improve safe abortion practices and reduce complications associated with unsupervised medical abortion.
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| Keyword:
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Medical abortion; MTP pills; Pharmacists; Over-the-counter drug sale; Knowledge attitude practice; Reproductive health; India; Abortion services.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2025.17.04.001
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| Download:
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