***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE : To investigate the knowledge and practice among private pharmacy staff in Hanoi regarding case management of mild acute respiratory infection ( ARI ) in children . METHODS : Sixty private pharmacies in Hanoi were r and omly selected . Knowledge was assessed through interviews with pharmacy staff using a question naire ; practice was assessed through the Simulated Client Method . RESULTS : In the question naire , 20 % of the pharmacy staff stated that they would dispense antibiotics . In practice , 83 % of the pharmacies dispensed antibiotics . Only 36 % of the cases were h and led according to guidelines . In the question naire , 81 % of interviewees stated that antibiotics are not effective in short therapeutic courses . In practice , 48 % of the antibiotics were dispensed in courses less than five days . Traditional herbal medicines were dispensed in 41 % of the encounters . In the question naire , 53 % of the pharmacy staff stated that they would ask the patient about difficulty of breathing . In practice , questions related to difficulty of breathing were asked in less than 10 % of the encounters . CONCLUSIONS : Dispensing of antibiotics for mild ARI was common practice among private pharmacies , and there was a significant difference between knowledge and practice . Interventions are needed to improve pharmacy practice in Hanoi SETTING Ho Chi Minh City ( HCMC ) , Vietnam . OBJECTIVES To assess knowledge about tuberculosis , to describe self-reported dispensing practice s and to estimate the magnitude of anti-tuberculosis drug dispensing in private pharmacies . DESIGN Survey of a r and om sample of 147 private pharmacies out of a total of 1814 registered pharmacies . Interviews were carried out based on a structured question naire . RESULTS Eighteen per cent of interviewees identified TB as a possible diagnosis for a fictitious case with fever and cough for 4 weeks . Fifty-eight per cent reported selling anti-tuberculosis drugs  often or sometimes . Interviewees estimated that 1.3 persons on average ( 95%CI 0.6 - 1.9 ) had bought  anti-tuberculosis drugs  during the last 4-week period , and that 24 % of them had bought  anti-tuberculosis drugs  without a prescription . CONCLUSION We have estimated that between 1100 and 3400 persons buy anti-tuberculosis drugs each month in the 1814 registered private pharmacies in HCMC , that about a quarter of them do so without a prescription , and that at least 40 % of all anti-tuberculosis drug dispensing in HCMC occurs in the private sector . Regulations need to be put in place urgently and collaboration strengthened between the strong National Tuberculosis Programme and the unorganised private sector in HCMC SETTING S Private pharmacies in Hanoi , Viet Nam . OBJECTIVES To explore the response of health care providers ( HCPs ) in private pharmacies to suspected tuberculosis ( TB ) patients . METHODS A simulated patient method combined with an interview in 128 r and omly selected private pharmacies and 10 private pharmacies near TB hospitals . RESULTS In the simulated patient method and interview , respectively 59 ( 46 % ) and 70 ( 55 % ) of HCPs referred the TB suspect to general health care . Only 11 ( 9 % ) referred the simulated patient to a TB care facility . Fifty-two ( 42 % ) of the HCPs identified suspected TB from a fictitious case described on paper ; 34 ( 27 % ) were aware that free treatment was provided under the National Tuberculosis Programme ( NTP ) . Knowledge about free NTP treatment predicted a higher rate of direct referrals to TB facilities ( OR 5.80 , 95%CI 1.88 - 19.62 ) and greater ability to identify suspected TB from a fictitious case on paper ( OR 5.14 , 95%CI 2.36 - 11.73 ) . Pharmacies with Good Pharmacy Practice ( GPP ) certification were less likely to refer simulated patients to TB facilities than non-GPP pharmacies ( OR 0.10 , 95%CI ≤0.01 - 0.79 ) . CONCLUSIONS Nearly half of HCPs in private pharmacies do not refer TB suspects , possibly contributing to delays in diagnosis and treatment . Knowledge about free NTP treatment predicted better performance of HCPs OBJECTIVES The study was conducted to assess how the general public in the Klang Valley , Malaysia , utilised community pharmacists . METHODS This was a prospect i ve observational study which documented interactions between community pharmacists and their customers . A research er was stationed in 10 participating community pharmacies around the Klang Valley to observe and record all the interactions , using a structured data - collection form . KEYS FINDINGS : Interactions between 1914 customers and the pharmacists of the 10 community pharmacies were recorded . A total of 2199 requests were made by these customers . The main types of request were for medications by br and name ( 32.2 % ) , advice on minor health problems ( 25.9 % ) and for health supplements ( 11.7 % ) . Only 65 prescriptions were received by the community pharmacies ; that is , fewer than two prescriptions per pharmacy per day . The pharmacists provided counselling for only 54.4 % of the requests where a medication or health supplement was dispensed . Counselling by pharmacist was significantly associated with the type of request ( P < 0.001 ) . CONCLUSIONS The main reason for the general public to visit a community pharmacy in Malaysia was to purchase a particular medication . Few prescriptions were filled at community pharmacies in Malaysia , indicating the under-utilisation of community pharmacists as a safety net for prescribed medications in primary care PURPOSE The purpose of this study was to evaluate the generic substitution ( GS ) practice s undertaken by community pharmacists in the State of Penang , Malaysia with a focus on the extent of communication between pharmacists and prescribers on issues related to GS , consumer 's acceptance on the GS and estimation of cost saving achieved for patients opted for GS . METHOD A cross-sectional descriptive study for a period of 2 months using a specific question naire as a data collection tool was undertaken with a r and om sample of 40 community pharmacies located in the State of Penang . RESULTS By the end of the study period , 34 out of 40 pharmacies contacted participated in the study . Forty-seven per cent of pharmacists consulted prescribers while promoting GS to their consumers . Majority of the prescribers ( 84.4 % ) when contacted by the pharmacists accepted the suggestion for substitution . From consumers ' perspective , 88 % ( n = 156 ) of the consumers involved in this study accepted pharmacist 's recommendation to generically substitute their prescribed medications . Through acceptance of GS , it has been estimated that the overall consumers ' expenses on drugs can be reduced to a total of RM6137 ( US$ 1615 ; US$ 1 = RM3.80 ) and this corresponds to a cost saving of 61.1 % . CONCLUSIONS The outcome of the present study showed that through GS recommendation by community pharmacist , consumers can save the expenditure of their prescribed medications Background The community pharmacist has significant potential to assist in providing health advice aim ed at the improvement outcomes pertaining to weight management , however , up to now , evidence regarding its effectiveness has been inconclusive . In Thail and , community pharmacy involvement in weight management is a novel idea and therefore needs an evaluation of its effectiveness . Objective To examine essential outcomes , comparing the pharmacist ’s interventions with a routine weight management service provided at a primary care unit ( PCU ) . Setting Maha Sarakham province , Thail and . Methods A r and omized controlled trial was design ed involving sixty-six obese patients r and omly assigned to either the control group or the experimental group . Participants in the control group received group counselling from the PCU staff as usual , while those participants in the experimental group received one-on-one advice from a community pharmacist along with the weight loss h and book for self- study . Both groups were followed up and clinical outcomes were monitored four times at weeks 0 , 4 , 8 , and 16 . Eating behaviours and knowledge about overweight and obesity were measured twice , at weeks 0 and 16 . Main outcome measure Clinical outcomes included weight , waist circumference , body mass index , measured by st and ard medical devices . Eating behaviours were measured by the theory of planned behaviour ( TPB ) question naire . Knowledge was measured by a question naire focusing on the subjects ’ level of underst and ing regarding overweight and obesity issues . Results Neither group showed improvement in clinical outcomes . The TPB average sum score significantly increased from baseline in the experimental group in terms of intention to perform healthy dieting behaviour , subjective norm , behavioural beliefs , normative beliefs , and control beliefs . ( P < 0.05 ) In the control group , scores increased significantly from the baseline only for behavioural beliefs . ( P < 0.05 ) Moreover , the knowledge score in experimental group increased significantly from 6.42 ± 1.94 to 8.75 ± 0.68 ( P < 0.05 ) . Conclusion Thai community pharmacists can help to improve both eating behaviour and knowledge about weight and obesity among obese patients . However , since the effect on clinical outcomes is unclear , a long-term study is still needed Private pharmacies are the first line of health care in many communities , commonly selling antibiotics in small doses and prescription-only drugs such as steroids without medical supervision . The aim was to study the effectiveness of a multi-faceted intervention on the dispensing practice s of drug sellers in Hanoi and Bangkok . The study was a r and omized , controlled trial with 68 Hanoi and 78 Bangkok pharmacies , r and omly selected and assigned for intervention and control . Behaviour was assessed by five simulated client visits per pharmacy per dispensing practice , at baseline and a month or more after each intervention . Three three-month interventions were implemented sequentially with four months in between : enforcement of regulations 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 Bangkok and compulsory in Hanoi . The intervention result ed 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 asking no questions and giving no 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 peer review 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 is dependant on the context and the method of implementation . Possible reasons for differences are discussed OBJECTIVES To describe practice behavior and underst and ing among pharmacy personnel , both pharmacists and  non-pharmacist staff , in the management of mild and moderate migraines . BACKGROUND Migraine is recognized as a prevalent and chronic neurological disorder . In developing countries , such as Thail and , community pharmacies are a widely used source of health care for various illnesses including migraine . However , the quality of migraine management and knowledge among pharmacy personnel is unclear . METHODS Cross-sectional study . The sample comprised 142 r and omly selected community pharmacies in a city in the south of Thail and . Simulated clients visited the pharmacies twice , at least 1 month apart , to ask for the treatment of mild and moderate migraines . After the encounters , question asking , drug dispensing , and advice giving by pharmacy staff were recorded . Subsequently , the providers in 135 pharmacies participated in the interview to evaluate their knowledge in migraine management . RESULTS The majority of pharmacy personnel were less likely to ask questions in cases of mild migraine when compared with moderate attack ( mean score [ full score = 12 ] 1.8 ± 1.6 vs 2.6 ± 1.5 , respectively , P < 0.001 ) . Mean difference of question asking between mild and moderate migraines was -0.8 ( 95 % confidence interval -1.1 to -0.5 , P < 0.001 ) . Approximately 33 % and 54 % of the providers appropriately dispensed  non-steroidal anti-inflammatory drugs  for mild attack and ergotamine for moderate migraine , respectively , P < 0.001 . Prophylactic medications ( eg , atenolol , propranolol , flunarizine ) were inappropriately recommended , particularly in moderate attack ( 28.2 % vs 17.6 % in mild migraine , P = 0.018 ) . Less than 30 % of providers advised the patients on the maximum limit of dose or discontinuity of medications when recovered . Compared with non-pharmacists , pharmacists tended to ask more questions , give more advice , and dispense less appropriately ; however , there were no significant differences . The results 
    Output:
    
The findings showed increasing interest in research into the delivery of pharmacy services and public health initiatives .
Overall , the review found that provision of some health services in pharmacies was common ; however , most public health initiatives appeared to be poorly implemented , had limited evidence and were not demonstrated to be sustainable across the sector .
This indicates that the practice of community pharmacy in the region has not significantly changed over the past 14 years with respect to the scope and quality of pharmacy services provided , and fundamental policy changes are necessary to improve this situation