Retail pharmacies in developing countries: A behavior and intervention framework
Retail pharmacies in developing countries: A behavior and intervention framework
复制标题
DOI：
10.1016/0277-9536(95)00388-6
复制
发表时间：
1996-04-01
影响因子：
5.4
通讯作者：
Soumerai, S
中科院分区：
文献类型：
--
作者：
Goel, P;RossDegnan, D;Soumerai, S
发展中国家的零售药店是最重要的药品咨询来源之一。客户给出的理由包括：容易获得;药品供应;服务质量（无需等待和方便的操作时间）;以及更便宜的产品、信贷供应或购买少量药品的选择。然而，零售药店工作人员开处方的适当性远远不能被接受。在儿童腹泻，例如，口服补液盐（ORS），适当的腹泻治疗，建议远远低于药物的价值有限，如抗运动剂，吸附剂等。在本文中，我们提出了一个概念框架，分析可能影响零售药店处方的因素，我们提出了改变行为的策略。我们在检视零售药房处方相关文献后，提出药房因素、顾客因素、医师执业及监管因素是了解药房处方行为的四组重要因素。在干预方面，我们提出了四种类型的干预措施，可以用来改变药房工作人员的行为：信息单独，说服，激励和强制。本文提出的行为和干预框架也应该有助于指导这一领域的进一步研究。例如，所有权类型的影响，可用性与专业人员的实际作用和权威结构对药房治疗行为的新信息将是未来研究的有用领域。同样，还需要进一步研究强制性，说服性和激励性策略对药房治疗行为的比较效果。
Retail pharmacies in developing countries are one of the most important sources of advice on pharmaceuticals. Among the reasons the clients give are ease of access; availability of medicines; quality of service (no waiting and convenient hours of operation); and cheaper products, availability of credit, or the option to buy drugs in small amounts. However, the appropriateness of prescribing by retail pharmacy staff has been found to be far from acceptable. In childhood diarrhea, for example, oral rehydration salts (ORS), the appropriate diarrhea treatment, are recommended much less than pharmaceuticals of limited value, such as antimotility agents, adsorbents, etc. Little information is available for reasons underlying such behaviors.In this paper, we present a conceptual framework in which to analyze factors that may affect retail pharmacy prescribing, and we suggest strategies for behavior change. We developed this framework after examining relevant literature on retail pharmacy prescribing.We propose that pharmacy factors, client factors, physician practice and regulatory factors are the four sets of important factors for understanding pharmacy prescribing behavior. For intervention, we present four types of interventions which could be used for changing the behavior of pharmacy staff: information alone, persuasion, incentives and coercion.The behavior and intervention frameworks presented in this paper should also help in guiding further research in this area. For example, new information on the effects of ownership type, availability vs actual role of professional staff and authority structure on pharmacy treatment behaviors would be useful areas for future research. Similarly, additional research is needed on the comparative effects of coercive, persuasive and incentive strategies on pharmacy treatment behaviors.