Knowledge, attitudes, and practices of retail pharmacy staff toward substandard and falsified dietary supplements in Northern Viet Nam, 2025

Background: Substandard and falsified dietary supplements (SF-DS) pose significant public health risks, including treatment failure, toxicity, and loss of consumer confidence. Retail pharmacy staff play a key role as the final checkpoint before these products reach the public, yet evidence regarding their knowledge, attitudes, and practices (KAP) toward SF-DS in Viet Nam remains limited. Objective: To assess the knowledge, attitudes, and practices of retail pharmacy staff toward SF-DS and identify associated factors. Subject and method: A cross-sectional study was conducted among 385 retail pharmacy staff from six provinces/cities in Northern Viet Nam (Ha Noi, Hai Phong, Hung Yen, Bac Giang, Quang Ninh, and Lang Son) between January and May 2025. Data were collected using a structured questionnaire consisting of demographic characteristics, knowledge (10 items), attitudes (12 items), practices (5 items), and training needs. Descriptive statistics and binary logistic regression were performed using SPSS version 20.0, with statistical significance set at p<0.05. Result: Participants had moderately good knowledge (mean=3.8/5); 78.5% recognized that SF-DS may contain banned substances. Attitudes were generally positive (mean=4.1/5), though 53.3% feared legal liability when unintentionally selling SF-DS. Practice gaps were notable, particularly in reporting suspected cases (29.3%). Experience >10 years (OR=2.15), prior training (OR=1.89), and higher education (OR=1.67) were significantly associated with more positive attitudes. Conclusion: While pharmacy staff show strong ethical awareness and good knowledge, practical implementation remains limited. Strengthening continuing professional development, formalizing SOPs, and improving reporting/traceability systems are essential to enhance SF-DS control.