Smith Felicity
Department of Practice and Policy, School of Pharmacy, University of London, Mezzanine Floor, BMA House, Tavistock Square, London, WC1H 9JP, UK.
Pharm World Sci. 2009 Jun;31(3):351-61. doi: 10.1007/s11096-009-9294-z. Epub 2009 Apr 3.
In low and middle income countries private pharmacies are considered a valuable resource for health advice and medicines in many communities. However the quality of the service they provide has often been questioned and is unclear. This paper reviews the evidence regarding the quality of professional services from private pharmacies in low and middle-income countries.
A literature search (computer and hand searches) was undertaken to identify all studies which included an assessment of the quality of some aspect of private pharmacy services in low and middle income countries.
30 studies were identified which spanned all regions in the developing world. These included 9 which examined the scope and/or quality of a range of professional services, 14 which assessed the quality of advice provided in response to specific symptoms and 7 which investigated the supply of medicines without a prescription. A range of methods were employed, in particular, questionnaire surveys with staff and/or clients and assessment of practice using simulated client methodology. Whilst many authors identified a potential for pharmacies to contribute more effectively to primary health care, virtually all studies identified deficiencies in the quality of current professional practice. In particular authors highlighted the lack of presence of pharmacists or other trained personnel, the provision of advice for common symptoms which was not in accordance with guidelines and the inappropriate supply of medicines.
The evidence-base regarding the quality of professional services from pharmacies in low and middle income countries is limited, but indicates that standards are often deficient. If pharmacists are to contribute effectively to health care, the barriers to the provision of higher quality care and ways in which these might be overcome must be identified and examined.
在低收入和中等收入国家，许多社区将私人药店视为获取健康建议和药品的宝贵资源。然而，其提供服务的质量常常受到质疑且尚不清楚。本文综述了关于低收入和中等收入国家私人药店专业服务质量的证据。
进行文献检索（计算机检索和手工检索），以识别所有包含对低收入和中等收入国家私人药店服务某些方面质量评估的研究。
共识别出30项研究，涵盖了发展中世界的所有地区。其中9项研究考察了一系列专业服务的范围和/或质量，14项评估了针对特定症状提供建议的质量，7项调查了无处方药品的供应情况。采用了多种方法，特别是对工作人员和/或客户进行问卷调查以及使用模拟客户方法评估实践情况。虽然许多作者认为药店有潜力更有效地为初级卫生保健做出贡献，但几乎所有研究都指出当前专业实践质量存在缺陷。特别是作者强调药剂师或其他受过培训的人员短缺、针对常见症状提供的建议不符合指南以及药品供应不当。
关于低收入和中等收入国家药店专业服务质量的证据基础有限，但表明标准往往存在缺陷。如果药剂师要有效地为医疗保健做出贡献，就必须识别并研究提供更高质量护理的障碍以及克服这些障碍的方法。
