In total, 52 pharmacies were identified, with the majority (58%) representing major chains. Folic acid was available in an otc prepatation in 35 of 52 pharmacies (67%); a further 12 (23%) had folic acid available in a multivitamin preparation only. The remaining five pharmacies (10%) did not have otc folic acid available. Jamieson® was the most common brand of folic acid, while Materna® (Lederle) was the most frequently identified multivitamin preparation. (Both contain 1 mg of folic acid per tablet.) Single preparation tablets of folic acid ranged from 3.5 to 5 cents (mean 4.1 cents), while multivitamins were more expensive, ranging from 11 to 25 cents per tablet (mean 17 cents). (Ten pharmacies were independently visited by two different investigators, with complete concordance of findings.) asthma inhalers
Only 21 of 52 pharmacists (40%) recommended fotic acid supplementation before conception, with the clinical justifications provided in Table 1. In 12 pharmacies (23%) the pharmacist indicated that fotic acid was available as a prescription drug only.
|TABLE 1Pharmacists’ clinical justifications for preconceptional folic acid supplementation|
|Clinical justification||Number (%)|
|Prevent birth defects||16 (76)|
|Prevent miscarriage||2 (1 0)|
|Prevent fetal anemia||1 (5)|
|Prevent Down’s syndrome||1 (5)|
|Reason not known||1 (5)|
There were no differences in pharmacist recommendation by type ofpharmacy or socioeconomic location. Female pharmacists, however, were significantly more likely to recommend folic acid supplementation before conception than male pharmacists (63% versus 31%, respectively, P=0.04).