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

The objective of this study was to assess the effects of a multicomponent intervention on private pharmacy practice. From 641 private pharmacies in Hanoi, 68 pharmacies were randomly selected and matched into 34 pairs. Each pair consisted of a control and an intervention pharmacy. Three interventions were applied sequentially: Regulatory enforcement, Education, and Peer influence. Four tracer conditions were selected: uncomplicated acute respiratory infection (ARI), sexually transmitted disease (STD), requesting the prescription-only drugs prednisolone, and a short course of cefalexin. Practice was assessed through the Simulated Client Method (SCM). The intervention pharmacies improved significantly compared to the control pharmacies (P.05) in all tracer conditions. For ARI, antibiotic dispensing decreased (P.02) and questions regarding breathing increased (P.01). For STD, advice to go to the doctor and dispensing the correct syndromic treatment increased (P.01). Dispensing of prednisolone and cefalexin decreased (P.01) and prescription requests increased (P.01). Our conclusion is that it is possible to improve private pharmacy practice with a multicomponent intervention.