Stenson B, Syhakhang L, Lundborg C S, Eriksson B, Tomson G
Karolinska Institutet.
Int J Technol Assess Health Care. 2001 Fall;17(4):579-89.
The objective of this study was to assess the effectiveness of government regulation of private pharmacy practice in a low-income country.
The intervention comprised inspections of the pharmacies, information, and distribution of documents to drug sellers and sanctions. It was implemented at two different intensity levels, active and regular intervention. The methods used to assess the effect of the interventions were interviews with the district drug inspectors, drug sellers and customers, inspection of drug purchases, and indicator surveys of pharmacies. Indicators for pharmacy-specific quality as well as for dispensing quality were developed.
The main finding was one of strong overall improvements from initially 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% to 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 greater improvements for four of the six indicators, although statistically significant compared with the regular intervention districts only for the essential materials indicator.
It was concluded that the regulatory activities have probably been an important factor behind the service quality improvements. It appeared feasible as well as effective to regulate private pharmacy practice in this particular low-income setting.
本研究的目的是评估低收入国家政府对私营药店执业进行监管的有效性。
干预措施包括对药店进行检查、向药品销售商提供信息和分发文件以及实施制裁。干预措施在两个不同强度水平上实施，即积极干预和常规干预。用于评估干预效果的方法包括与地区药品检查员、药品销售商和顾客进行访谈、检查药品采购情况以及对药店进行指标调查。制定了药店特定质量指标和配药质量指标。
主要发现是，从最初的低水平总体上有了显著改善。改善尤其明显的是，配药基本材料的可获得性提高了34%，药店的整洁程度提高了19%。向顾客提供的信息从35%增加到51%，不同药品混装在同一包装中的情况从17%降至9%。积极干预地区的药店在六个指标中的四个指标上有更大改善，不过仅在基本材料指标方面与常规干预地区相比具有统计学显著性。
得出的结论是，监管活动可能是服务质量提高背后的一个重要因素。在这个特定的低收入环境中，对私营药店执业进行监管似乎既可行又有效。
