Objective
To analyse and compare the historical development of the regulatory system for private pharmacies and its implementation in Thailand and Vietnam;
To develop evaluation tools to describe the situation of drug distribution practices (dispensing, prescribing, informing, advising and storage in private pharmacies);
To analyse factors which may influence drug distribution practice such as government regulation and provider knowledge;
To develop a conceptual framework on the basis of findings describing the inter-relationships between drug distribution practices and influencing factors in Thailand and Vietnam;
To develop a context-specific multi-component intervention package including enforcement of regulation, education and peer-influence strategies;
To evaluate the effectiveness of each intervention on drug distribution practice in private pharmacies through a randomised control trial (modified time-series design);
To develop a comprehensive package of evaluation tools and context-specific interventions to be proposed to policy-makers in order to improve drug use in private pharmacies.
Expected Outcome
* The study will provide an analysis of drug distribution practices in private pharmacies in Thailand and Vietnam.
* The study will evaluate the feasibility and effectiveness of a multi-component intervention on drug-distribution practices.
* The intervention and monitoring instruments of GPP developed in this study will be adapted to the health services.
* The results will provide policy-makers with a scientific basis for decisions relating to national drug-policy reform including privatisation of the drug-distribution system as part of the health sector reform.
* The project will result in capacity building and research training which, will be useful for the development of GPP in the Asian region.
* Analysis of regulatory processes (objective 1). Conducting an historical policy analysis of the contextual factors which have affected the development of the regulatory system for private pharmacies as well as of actors taking part in the process, whether as stakeholders or in opposition to policies. The focus will be on the process of translating policy into successful implementation in Vietnam and Thailand.
* Provider drug-distribution knowledge (objectives 2 & 3). Provider knowledge in relation to Good Pharmacy Practice (GPP) including case management will be studied from a formal point of view through official visits to pharmacies using a pre-tested questionnaire and through interviews assessing pharmacy staffs' knowledge and conceptions. These questions will focus on the pharmacists' own practice and their knowledge and attitudes towards case management and GPP, including the essential drug (ED)-concept and adverse drug reaction (ADR). Knowledge of the use of oral steroids for lower back pain treatment and of the use of short courses of antibiotics for viral infections will be assessed.
* Provider drug-distribution practice (objectives 2 &3). Trained research assistants will present histories of e.g. ARI, STD, and infant diarrhoea at the pharmacy, posing as patients or parents asking the drug outlet staff for advice on treatment, i.e. surrogate patient survey methodology. Low back pain case management and the use of short term courses of antibiotics will also be assessed. The drugs sold will be noted, including their quantity, formulation, strength, price to client, presence of generic name and information given.
* Provider system for stocking, etc. (objectives 2 & 3). A stock inventory will be conducted using a pre-tested protocol, monitoring essential drug selection and drug registration, labelling (presence of generic name), proportion of banned and combination drugs, number of drugs beyond expiry date, unit cost from wholesalers, price to buyer, availability, quality, etc.
* Conceptual framework and interventions (objectives 4, 5 & 6). The results of these investigations will provide the basis for the development of a conceptual framework describing the interrelationship between drug-distribution practices and influencing factors. A context-specific multi-intervention package including enforcement of regulation, education/persuasive information and peer-influence strategies will be developed. The feasibility and effectiveness of the interventions on drug distribution practice in private pharmacies will be assessed through a randomised control trial with 40 pharmacies in each country. The interventions will be applied sequentially in a modified time-series design with a parallel control group.
* Exploitation and dissemination (objective 7). The results will be disseminated through publications in national and international scientific journals, mass media, and relevant professional organisations. The conclusions will be disseminated to key actors and organisations involved in health system research, drug policy-making and health sector reforms. The project will seek ways to improve the feasibility of implementing the project innovations within a specific political context.
Fields of science (EuroSciVoc)
CORDIS classifies projects with EuroSciVoc, a multilingual taxonomy of fields of science, through a semi-automatic process based on NLP techniques. See: The European Science Vocabulary.
CORDIS classifies projects with EuroSciVoc, a multilingual taxonomy of fields of science, through a semi-automatic process based on NLP techniques. See: The European Science Vocabulary.
- humanities history and archaeology history
- medical and health sciences basic medicine pharmacology and pharmacy pharmaceutical drugs antibiotics
- medical and health sciences basic medicine pharmacology and pharmacy adverse drug reactions
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Coordinator
171 77 Stockholm
Sweden
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