Private pharmacy practice and regulation - A randomized trial in Lao PDR

Objectives: The objective of this study was to assess the effectiveness of government regulation of private pharmacy practice in a low-income country. Methods: The intervention comprised inspections of the pharmacies, informat ion, and distribution of documents to drug sellers and sanctions. It was im plemented at two different intensity levels, active and regular interventio n. The methods used to assess the effect of the interventions were intervie ws with the district drug inspectors, drug sellers and customers, inspectio n of drug purchases, and indicator surveys of pharmacies. Indicators for ph armacy-specific quality as well as for dispensing quality were developed. Results: The main finding was one of strong overall improvements from initi ally low levels. The improvements were particularly marked by increases in the availability of essential materials for dispensing by 34% and in order in the pharmacy by 19%. Information given to customers increased from 35% t o 51% and the mixing of different drugs in the same package went down from 17% to 9%. The pharmacies in the active intervention districts showed great er improvements for four of the six indicators, although statistically sign ificant compared with the regular intervention districts only for the essen tial materials indicator. Conclusions: It was concluded that the regulatory activities have probably been an important factor behind the service quality improvements. It appear ed feasible as well as effective to regulate private pharmacy practice in t his particular low-income setting.