Private pharmacy practice and regulation. A randomized trial in Lao P.D.R

Area of Science:

• Public Health
• Health Policy
• Pharmaceutical Sciences

Background:

• Private pharmacies play a crucial role in healthcare delivery, especially in low-income countries.
• Effective regulation is essential to ensure quality and safety in private pharmacy practice.
• Limited evidence exists on the impact of government regulation on private pharmacies in resource-limited settings.

Purpose of the Study:

• To evaluate the effectiveness of government regulatory interventions on private pharmacy practice.
• To assess the impact of different intervention intensities (active vs. regular) on pharmacy quality.
• To determine the feasibility and impact of regulating private pharmacies in a low-income country.

Main Methods:

• Implementation of a regulatory intervention including inspections, information dissemination, and sanctions.
• Two intervention intensity levels: active and regular.
• Assessment through interviews with inspectors, drug sellers, and customers; drug purchase inspections; and pharmacy indicator surveys.

Main Results:

• Significant improvements observed in overall pharmacy quality from initially low levels.
• Key improvements included a 34% increase in essential dispensing materials and a 19% increase in pharmacy organization.
• Customer information improved (35% to 51%), and drug mix-ups decreased (17% to 9%).

Conclusions:

• Government regulatory activities were likely a key driver of service quality improvements.
• Regulating private pharmacy practice was found to be feasible and effective in this low-income setting.
• The findings support the implementation of regulatory frameworks for private pharmacies in similar contexts.