Private pharmacies are the first line of health care in many communities, commonly sellingantibiotics in small dosesand prescription-only drugs such as steroids without medical supervision. The aim was to study the effectiveness of amulti-faceted intervention on the dispensingpractices of drugsellers in Hanoi and Bangkok.The study was a randomized, controlled trial with 68 Hanoi and 78 Bangkok pharmacies, randomly selected andassigned for intervention and control. Behaviour was assessed by five simulated client visits per pharmacy perdispensingpractice, at baseline and a month or more after each intervention.Three three-month interventions were implemented sequentially with four months in between: enforcement ofregulations with local inspectors visiting to emphasize the importance of prescription-only medicine legislation;education, performed face-to-face in Hanoi and by a large group in Bangkok; and peer review, voluntary in Bangkokand compulsory in Hanoi.The intervention resulted in significant improvements in Hanoi, reducing the dispensing of illegal steroids (29% vs.62%) and low dose antibiotics (69% vs. 90%), sustained by means of the peer review (17% vs. 57% steroids and 71%vs. 95% antibiotics), and in fewer dispensers askingno questions and givingno advice (11% vs. 30% steroids and 51%vs. 81% antibiotics). The only significant improvement in Bangkok was the reduction in illegally dispensing steroids(25% vs. 44%) after the regulatory intervention. In Bangkok, fewer of those in the group who volunteered for the peerreview asked no questions and gave no advice for low-dose antibiotics requests after the peer review (58% vs. 81%).A multi-component intervention can have a profound effect in changing dispensers’ behaviour, but the effect isdependant on the context and the method of implementation. Possible reasons for differences are discussed

Social Science and Medicine ปี 2548, ปีที่: 60 ฉบับที่ 1 หน้า 131-141

Thailand, Educational, enforcement;, interventions;, Peer, pharmacies;, Private, Regulation, review;, Vietnam;