Do, Xuan Thang
(2013)
An investigation of non-prescription medicine supply in community pharmacies in Hanoi, Vietnam.
PhD thesis, University of Nottingham.
Abstract
Supplying safe, appropriate and effective non-prescription medicines for customers in community pharmacies is a key role of pharmacists and pharmacy assistants in every country. However, in low and middle-income countries, including Vietnam, the quality of professional services from pharmacies is limited, unclear and has often been questioned. There is limited research about the real situation surrounding non-prescription medicine supply in community pharmacies in Vietnam. The factors that influence the supply of non-prescription medicines to customers and to what extent the service provision could be improved for the benefit of pharmacy customers needs to be explored. This study aimed to investigate non-prescription medicines supply in community pharmacies in Hanoi, Vietnam in order to provide scientific evidence about the situation.
A mixed method approach was used in this study to provide valuable insights into what occurs during pharmacy staff-customer transactions. Following ethical approval, fieldwork observations were undertaken in five community pharmacies over a five week period from March to May 2011, this was followed by 22 semi-structured interviews with eight pharmacists and 14 pharmacy assistants who had been observed. The interviews enabled participants to express their perceptions and experiences regarding the supply of non-prescription medicines to customers in community pharmacies. Survey research, using a structured questionnaire, was conducted with 505 pharmacy customers who were asked to evaluate the pharmacy service that they had just received. Results from the three sources were triangulated and validated by comparing, contrasting, complementing and confirming in order to provide a better understanding of non-prescription medicines supply and make recommendations for improving the service provision in community pharmacies in Vietnam.
The findings from this study indicate that factors influencing the supply of non-prescription medicines in community pharmacies include attitudes of pharmacy staff, their medical and pharmaceutical knowledge and their communication skills. The influence of the pharmacy settings, customer factors such as customers’ complex and diverse demands, the irrational use of medicines, using medicines following the suggestions of others, and tough customers were all factors that impacted on staff-customer transactions. Being conveniently located, the pharmacy offering reasonably priced medicines and being a large pharmacy with a good reputation were also considered important impacting on customer selection of community pharmacy.
The results of this research show that there are limitations in pharmacy service provision and there is a discrepancy between pharmacy staff perceptions and actual practice in terms of attitudes. Poor performance, in many situations, did not come from a lack of knowledge; rather it appeared to result from the negative attitudes of pharmacy staff. Such negative attitudes of pharmacy staff are likely to be related to their focus on just short-term profit rather than focusing on a balance between short-term and long-term benefits for both customers and pharmacies. Positive attitudes, taking greater responsibility, customer loyalty and long-term benefits were ignored. Poor performance of pharmacy staff, to some extent, was also affected by their education and training. Some educational organisations have commercialised their training activities and paid too much attention to the quantity of graduated students rather than the quality of their education and training.
This study has important implications for the improvement of the responsible supply of non-prescription medicines in community pharmacies in Vietnam including the identified needs for attitude interventions and training. New subjects should be added to the pharmacy students’ curricula and training should be developed for pharmacy assistants in areas such as communication skills, customer psychology, selling skills and patient safety. For pharmacists and pharmacy assistants, gaining treatment experience from customers’ feedback and keeping up to date with new information should be a continuous activity. Close co-operation between health authorities, policy makers and researchers needs to be developed in conducting further research and implementing appropriate policies, in order to improve the service provision in community pharmacies in Vietnam.
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