Improving private pharmacy practice: a multi-intervention experiment in Hanoi, Vietnam

Area of Science:

• Pharmaceutical Practice
• Public Health Interventions
• Health Services Research

Background:

• Private pharmacies play a crucial role in healthcare delivery, particularly in managing common conditions.
• Variations in pharmaceutical practice can impact patient outcomes and antimicrobial resistance.
• Standardizing and improving private pharmacy services is essential for public health.

Purpose of the Study:

• To evaluate the effectiveness of a multicomponent intervention aimed at enhancing private pharmacy practice.
• To assess changes in dispensing behaviors and patient counseling for specific health conditions.

Main Methods:

• A randomized controlled trial was conducted in 68 private pharmacies in Hanoi, Vietnam, matched into 34 pairs.
• Interventions included regulatory enforcement, education, and peer influence, applied sequentially.
• The Simulated Client Method (SCM) was used to assess practice across four tracer conditions: acute respiratory infection (ARI), sexually transmitted disease (STD), and requests for prednisolone and cefalexin.

Main Results:

• Intervention pharmacies showed significant improvements compared to control pharmacies across all tracer conditions (P <.05).
• For ARI, antibiotic dispensing decreased (P <.02) and relevant questions increased (P <.01).
• For STD, appropriate advice and syndromic treatment dispensing increased (P <.01), while dispensing of restricted drugs (prednisolone, cefalexin) and inappropriate prescription requests decreased (P <.01).

Conclusions:

• A multicomponent intervention is effective in improving the quality of private pharmacy practice.
• Targeted interventions can lead to more appropriate antibiotic use and better management of STDs in community pharmacies.
• The findings support the scalability of such interventions to enhance pharmaceutical care in similar settings.