Private pharmacies in Hanoi, Vietnam: a randomized trial of a 2-year multi-component intervention on knowledge and stated practice regarding ARI, STD and antibiotic/steroid requests
Chalker, J.; Chuc, N.T.K.; Falkenberg, T.; Tomson, G.
Tropical Medicine and International Health Tm and Ih 7(9): 803-810
2002
ISSN/ISBN: 1360-2276 PMID: 12225513 DOI: 10.1046/j.1365-3156.2002.00934.xDocument Number: 243425
OBJECTIVES: To assess the effectiveness of a multi-component intervention on knowledge and reported practice amongst staff working in private pharmacies in Hanoi regarding four conditions: urethral discharge (sexually transmitted diseases (STD)), acute respiratory infection (ARI), and non-prescription requests for antibiotics and steroids. METHOD: Randomized controlled trial with staff working in 22 matched pair intervention and control private pharmacies who were administered a semistructured questionnaire on the four conditions before and 4 months after the interventions. The interventions focused on the four conditions and were in sequence (i) regulations enforcement; (ii) face-to-face education and (iii) peer influence. Outcome measures were knowledge and reported change in practice for correct management of tracer conditions. RESULTS: The intervention/control-pairs (22 after drop-outs) were analysed pre- and post-intervention using the Wilcoxon signed rank test. STD: More drug sellers stated they would ask about the health of the partner (P=0.03) and more said they would advise condom use (P=0.01) and partner notification (P=0.04). ARI: More drug sellers stated they would ask questions regarding fever (P=0.01), fewer would give antibiotics (P=0.02) and more would give traditional medicines (P=0.03). Antibiotics request: Fewer said they would sell a few capsules of cefalexin without a prescription (P=0.02). Steroid requests: No statistical difference was seen in the numbers who said they would sell steroids without a prescription as numbers declined in both intervention and control groups (P=0.12). CONCLUSION: The three interventions in series over 17 months were effective in changing the knowledge and reported practice of drug sellers in Hanoi.