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A SECULAR TREND?
Given below are data gathered on the number of prescriptions for albuterol (Ventolin) in four health centres in Bahrain during the first 8 months of the years 1989-1991. Bahrain is an archipelago located in the Arabian Gulf, 320 km to the southeast of Kuwait. The population (516,444) is served by a well-developed medical system provided by a combination of a government health service and the private sector. In the government health care centres, acute asthmatic attacks are treated with albuterol nebulisers. The data are obtained from the centres in Muharraq, Nai'm, Hoora and Sheik Sabah.
This problem was used in my 4th year course which dealt with social aspects of pharmacology. Here students were expected to find possible explanations for the variations in prescriptions written. Many explanation were given ranging from the appearance of the drug in the formularies, aggressive marketing, non-availability of other medications, some even remembered the Gulf War!