A comparative study of the impact of prescription and non-prescription mucolytic agents on respiratory disease management in a community-based population.

INTRODUCTION: Respiratory disease significantly impacts quality of life at the same time economic burden. Mucolytic agents are widely used in respiratory diseases such as chronic obstructive pulmonary disease (COPD), asthma, and upper respiratory tract infections (URTIs). However, real-world differences in clinical outcomes between prescription-guided and over-the-counter (OTC) mucolytic use in community settings remain inadequately characterized. OBJECTIVE: The present study aimed to compare symptom improvement and adverse effects between prescription based and OTC mucolytic users, and to evaluate patterns of usage and healthcare seeking behaviour consultation in a community setting. METHODS: A longitudinal observational study conducted among 200 participants categorized into OTC and prescription groups conducted after getting institutional Ethical approval (BVDUMC/IEC/399/25-26). Data collected using structured questionnaires assessing symptom scores, adverse effects, and healthcare utilization. Statistical analysis included descriptive statistics and Chi-square test. A p value of <0.05 was considered statistically significant. Ethical approval was obtained before starting the study. RESULTS: The prescription group demonstrated a statistically significant improvement in symptoms, with mean COPD Assessment Test (CAT) scores decreasing from 21 to 18 (p < 0.01). In contrast, the OTC group exhibited a significant worsening of symptoms, with mean scores increasing from 26.5 to 30 (p < 0.01). Prescription-based therapy was associated with better symptom control, appropriate drug selection, and adherence to recommended dosing regimens. Conversely, OTC use was characterized by inconsistent dosing, inappropriate drug selection, and suboptimal therapeutic outcomes. The incidence of adverse drug reactions was slightly higher in the Prescription group, predominantly gastrointestinal in nature. Furthermore, awareness regarding appropriate indications, dosage, and duration of mucolytic therapy was significantly lower among OTC users. CONCLUSION: Prescription mucolytic therapy demonstrated better outcomes compared to OTC use, likely due to structured treatment and medical supervision. These findings indicate the importance of rational prescribing and patient education in respiratory disease management.