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Intervention experience in neighborhood stores
and community drugstores in the
Philippines  Isidro C Sia, Rainier M Galang,
Ophelia M Mendoza, Judith A Reyes, Anna Margarita
A Bernardo, Dexter T Estrada, Cristina O Quiroga,
Aldrin C Santiago, Julie Valerio Drug Use Study
Group, University of the Philippines Manila
and National Drug Information Center
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Setting characteristics

• gt Major sources of drugs
• Neighborhood stores 42
• Community drugstores 35

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Problems

• Sellers have no training in dispensing
• Practices of neighborhood store sellers
• Sell antibiotic or other drugs on request
• Recommend and sell more expensive popular branded
  drugs for fever
• Practices of community drugstore sellers
• Dispense antibiotics without prescription
• Recommend antibiotic when none is needed
• Fill erroneous prescriptions

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Intervention approach

• Neighborhood store sellers
• Informal group discussion
• in situ
• with store seller and by-standers
• focus on key messages

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Intervention approach

• Community drugstore sellers
• Moderated interactive group discussion
• 2 hour discussion with sellers and mothers
• Leaflets
• Focus on key messages
• Drugstore visit
• 5 to 10 minute visit
• Leaflets
• Focus on key messages

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Behavior change

• Neighborhood store sellers
• Informal group discussion
• Decrease in selling amoxicillin or cotrimoxazole
  for children
• No change in recommending and selling more
  expensive popular branded paracetamol

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Behavior change

• Community drugstore sellers
• Interactive group discussion
• No change in filling erroneous prescription
• Decrease in dispensing of amoxicillin for a child
  with ARI
• Decrease in recommending antibiotic for flu
  symptoms
• Drugstore visit
• No behavior change

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• Behavior influenced by
• Consumer expectations
• Economic interest of neighborhood store owner and
  community drugstore owner
• Perception of infallibility of the prescriber
• Concern for safety of use of antibiotic in
  children

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Key elements for sustainability

• Comprehensive approach to address stakeholders
• Education of consumers
• Education of drug sellers and pharmacists
• Incentives for drugstore owners
• Education of prescribers
• Setting and enforcement of standards of practice
• Harmonized educational messages for
• Prescribers
• Drugstore sellers, pharmacists and drugstore
  owners
• Neighborhood store sellers
• Consumers

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Policy and research

• Policy
• Legal regulatory framework vs realities and
  intervention needs
• Minimum standards of dispensing practices in
  drugstores
• Research
• Combination of interventions educational and
  regulatory
• Interventions involving different stakeholders in
  the community setting prescriber, drugstore
  owner, drugstore seller, consumer