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

Authors

  • J. Chalker,

    1. 1Management Sciences for Health, Arlington, VA, USA 2Hanoi Medical University, Hanoi Vietnam 3Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
    Search for more papers by this author
  • 1 N. T. K. Chuc,

    1. 1Management Sciences for Health, Arlington, VA, USA 2Hanoi Medical University, Hanoi Vietnam 3Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
    Search for more papers by this author
  • 2 T. Falkenberg,

    1. 1Management Sciences for Health, Arlington, VA, USA 2Hanoi Medical University, Hanoi Vietnam 3Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
    Search for more papers by this author
  • and 3 G. Tomson 3

    1. 1Management Sciences for Health, Arlington, VA, USA 2Hanoi Medical University, Hanoi Vietnam 3Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
    Search for more papers by this author

John Chalker, Management Sciences for Health, Suite 400, 4301 N Fairfax Drive, Arlington, VA 22203-1627, USA. Fax: +1-703-248-1635; E-mail: chalkerj@compuserve.com

Summary

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.

Ancillary