1
|
Arslan M, Başak H. Modeling individuals' prescription medicine borrowing behavior. Res Social Adm Pharm 2024; 20:84-91. [PMID: 38448257 DOI: 10.1016/j.sapharm.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Medicine-sharing behavior can be divided into two groups: borrowing medicine from someone else and lending medicine to someone else without consulting a doctor or a pharmacist. There are many reasons for the behavior that leads individuals to share their prescription medicines. However, there is a lack in the literature to investigate individuals' medicine-sharing behavior and related antecedents and outcomes of this behavior. OBJECTIVE(S) The main objective of this study is to model individuals' prescription medicine borrowing (PMB) behavior via the structural equation model based on the Theory of Planned Behavior (TPB). METHODS A measurement tool was developed according to TPB. Exploratory factor analysis was conducted to determine subfactors of PBM behavior. In the second step, confirmatory factor analysis (CFA) was conducted to confirm whether there is a relationship between the observed variables and their underlying latent constructs. Finally, a structural equation model was conducted to specify the relationships between latent variables. IBM Statistical Package for Social Sciences (IBM SPSS Software) version 22 and LISREL 8.80 were used for data analysis. RESULTS Study findings reveal that the participants' attitudes and intentions towards PMB are low, and the rate of exhibiting this behavior is also low. In the proposed prescription medicine borrowing behavior model, the positive effect of attitude towards PMB, perceived behavioral control related PMB, and subjective norm about PMB on intention towards PMB were found statistically significant. Intention towards PMB has been found to have a positive statistically significant effect on PMB behavior. CONCLUSIONS Based on the results of this study, it is possible to say that TPB is an appropriate theory for modeling PMB. Thus, this model will shed light on healthcare providers and policy-makers to avoid individuals from the adverse effects of PMB behavior.
Collapse
Affiliation(s)
- Miray Arslan
- Department of Pharmacy Management. Faculty of Pharmacy, Van Yüzüncü Yıl University, 65080, Van, Turkey.
| | - Havva Başak
- Faculty of Pharmacy, Van Yüzüncü Yıl University, Van, Turkey
| |
Collapse
|
2
|
Lin R, Duan L, Liu C, Wang D, Zhang X, Wang X, Zhang X, Wang Q, Zheng S, Liu C. The public's antibiotic use behavioural patterns and their determinants for upper respiratory tract infections: a latent class analysis based on consumer behaviour model in China. Front Public Health 2023; 11:1231370. [PMID: 38162628 PMCID: PMC10754980 DOI: 10.3389/fpubh.2023.1231370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Background The irrational use of antibiotics among the public is a major contributor to antimicrobial resistance (AMR), which is a serious global threat. Prior studies have demonstrated that there are different behavioural patterns regarding antibiotic use among the public, and targeted interventions for subgroups with different behavioural patterns may be more effective. Thus, this study aimed to identify the public's behavioural patterns of antibiotic use for upper respiratory tract infections (URTIs) and their influencing factors. Methods A cross-sectional survey was conducted among the general population in Chongqing, China. Consumer decision-making (Consumer Behaviour Model, CBM) was used to assess the public's behaviours regarding antibiotic use, including need recognition, information searching, alternative evaluation, obtaining antibiotics, antibiotic consumption, and postuse evaluation. Furthermore, a latent class analysis was used to identify the underlying behavioural patterns among the public. The identified behavioural patterns of antibiotic use were further linked with individuals' capacity, opportunity, and motivation factors of antibiotic use based on a multinominal logistic regression to explore possible determinants. Results A total of 815 respondents were enrolled in the study. The public's irrational use of antibiotics was prevalent, including antibiotic self-medication (39.63%), nonprescription antibiotic purchasing (59.02%), and early stopping of antibiotic prescriptions (76.56%). Participants had inadequate knowledge of antibiotics (Mean = 2.33, SD = 1.71), reported high availability to antibiotics (Mean = 7.13, SD = 2.41), held strong belief in antibiotic effectiveness (Mean = 10.29, SD = 2.71), and demonstrated a high perceived threat of AMR (Mean = 12.30, SD = 3.20). Four behavioural patterns regarding antibiotic use for URTIs were identified, namely, "antibiotic self-medicators" (n = 165, 20.25%), "formal health care seekers" (n = 216, 26.50%), "various treatment users" (n = 198, 24.20%), and "self-medication without antibiotics" (n = 236, 28.96%). Individuals' self-efficacy of antibiotic use, belief in antibiotic effectiveness, awareness of antibiotic side effects, perceived antibiotic availability, social influence, and demographics (age, education, medical insurance, and having a medical background) were significantly associated with the public's different behavioural patterns of antibiotic use for URTIs. Conclusion This study calls for collaborative efforts among the public, physicians, policy makers, and the implementation of precise and multifaceted interventions to effectively reduce irrational use of antibiotics in the public. Such interventions include identifying subgroups within the public to provide more targeted education about antibiotics and the management of URTIs, reinforcing the regulation of antibiotic dispensing, and improving physicians' rational antibiotic prescriptions.
Collapse
Affiliation(s)
- Rujiao Lin
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lixia Duan
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Dan Wang
- School of Management, Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xi Wang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xinyi Zhang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qianning Wang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shuangjiang Zheng
- Department of Medical Affairs, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chenxi Liu
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| |
Collapse
|
3
|
Widyakusuma NN, Suryawati S, Wiedyaningsih C, Probosuseno. What Do Seniors Believe About Medication Adherence? A Qualitative Study Among Seniors with Chronic Conditions in Yogyakarta, Indonesia. Patient Prefer Adherence 2023; 17:1381-1392. [PMID: 37312872 PMCID: PMC10259584 DOI: 10.2147/ppa.s412981] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/25/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose This qualitative study elicited beliefs about medication adherence among hypertensive seniors with polypharmacy. Methods Twenty-one participants aged 60 or older with hypertension and other chronic conditions, with or without their family caregivers, residing surrounding Yogyakarta province, using five medicines or more routinely, were semi-structuredly interviewed by one researcher or one research assistant in January to April 2022. Behavioral, normative, and control beliefs were elicited using an interview guideline which was developed based on the Theory of Planned Behavior approach. Thematic analysis was applied. Results The participants believed that taking medicines routinely was advantageous because the medicines kept their body in good condition and prevented disease worsening. However, there were concerns about the medications' harmful effects on kidneys, gastric, and the whole body, and that the medicines would not be effective anymore. Prescribers, family, and friends would likely approve of medication adherence. However, non-prescriber doctors, family, and neighbors, mainly those with experience with complementary/alternative medicines, would likely disapprove of medication adherence. Good physical and cognitive function, help from family and technology, mealtime regularity, a simple regimen and easy-to-read medication labeling, and good communication with prescribers were among the facilitators of medication adherence. Physical and cognitive decline, mealtime irregularity, tablets that must be cut before taken, insurance that does not cover all medicines, change in dosage regimen, and hard-to-tear-off medication packaging were among the barriers to medication adherence. Conclusion Understanding these beliefs yields insights into the health communication approaches to improving seniors' medication adherence.
Collapse
Affiliation(s)
- Niken Nur Widyakusuma
- Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Sri Suryawati
- Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Probosuseno
- Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| |
Collapse
|
4
|
Sychareun V, Phounsavath P, Sihavong A, Kounnavong S, Chaleunvong K, Machowska A, Keohavong B, Mayxay M, Eriksen J, Hanson C, Vongsouvath M, Brauner A, Durham J, Stålsby Lundborg C. Perceptions and reported practices of pregnant women and mothers of children under two years of age regarding antibiotic use and resistance in Vientiane province, Lao PDR: a qualitative study. BMC Pregnancy Childbirth 2022; 22:569. [PMID: 35842597 PMCID: PMC9287906 DOI: 10.1186/s12884-022-04894-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 07/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding pregnant women and mothers' perceptions towards antibiotic use and resistance is essential for appropriate antibiotic use and limiting antibiotic resistance. This study aimed to explore perceptions and reported practices of pregnant women and mothers with children under two years of age regarding correct antibiotic use and antibiotic resistance in Vientiane Province, Lao PDR. METHODS The study employed an exploratory qualitative research design using focus groups discussions (FGDs). Participants were purposively selected based on: being pregnant at third trimester and attending antenatal care and mothers with children under two years of age, attending the health facility for postpartum visit /vaccinations. Six focus group discussions were conducted in September 2019 with a total of 55 women. The FGDs were transcribed verbatim, data were analyzed first by coding then categorizing the data as we looked for patterns and themes by using the qualitative content analysis. RESULTS Most participants had some understanding of antibiotics but wrongly believed antibiotics can be used to treat viral disease. Over half of the participants had heard the term "antibiotic resistance", but often believed it was their bodies, not the bacteria that developed antibiotic resistance. During pregnancy and for their infants, women preferred to use antibiotics only when prescribed by a doctor. Outside of pregnancy however, consuming antibiotics without a prescription was commonly reported. Participants wanted more information about the indications for antibiotic use and antibiotic resistance. CONCLUSIONS More effort is required to increase the level of understanding, and practice of mothers to promote optimal antibiotic use. Mothers' desire to learn more, and their fundamental concern for their children, can be used to promote appropriate antibiotic use. Awareness raising should be complemented by efforts to address other determinants of inappropriate antibiotic use, including educating healthcare workers, and pharmacists and addressing health service determinants that contribute to inappropriate antibiotic use.
Collapse
Affiliation(s)
- Vanphanom Sychareun
- Faculty of Public Health, University of Health Sciences (UHS), Vientiane, Lao PDR
| | | | - Amphoy Sihavong
- Vientiane Capital Health Department, MOH, Vientiane, Lao PDR
| | - Sengchanh Kounnavong
- Lao Tropical & Public Health Institute, Ministry of Health (MOH), Vientiane, Lao PDR
| | | | - Anna Machowska
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Mayfong Mayxay
- Institute of Research and Education Development, UHS, MOH, Vientiane, Lao PDR.,Lao-Oxford-Mahosot Hospital-Welcome Trust Research Unit (LOMWRU), Microbiology. Laboratory, Mahosot Hospital, MOH, Vientiane, Lao PDR.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jaran Eriksen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden. .,Department of infectious diseases, Stockholm South General Hospital, Stockholm, Sweden.
| | - Claudia Hanson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Manivanh Vongsouvath
- Lao-Oxford-Mahosot Hospital-Welcome Trust Research Unit (LOMWRU), Microbiology. Laboratory, Mahosot Hospital, MOH, Vientiane, Lao PDR
| | - Annelie Brauner
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Jo Durham
- Faculty of Health, Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | | |
Collapse
|
5
|
Khan X, Lim RHM, Rymer C, Ray P. Fijian Farmers' Attitude and Knowledge Towards Antimicrobial Use and Antimicrobial Resistance in Livestock Production Systems–A Qualitative Study. Front Vet Sci 2022; 9:838457. [PMID: 35433900 PMCID: PMC9007610 DOI: 10.3389/fvets.2022.838457] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
Antimicrobial resistance (AMR) is a global health issue affecting humans and livestock. To mitigate AMR risks, responsible use of antimicrobials in livestock production systems have been advocated. Studies have reported patterns of antimicrobial use (AMU) in livestock production systems; however, there is limited information on the drivers of AMU and AMR. Therefore, this study aimed to explore and understand the attitude and knowledge of Fijian livestock farmers on AMU and AMR. Livestock farmers and managers from the Central and Western divisions of Viti Levu, Fiji were recruited using purposive and snowball sampling methods. Face-to-face one-to-one semi-structured qualitative interviews were conducted. Interview questions were informed by the Theory of Planned Behavior (TPB). Interview transcripts were analyzed inductively using reflexive thematic analysis and deductively using the TPB framework. A total of 19 cattle and poultry farmers took part. Our analysis generated four themes: (1) Uninformed use of antimicrobials and unaware of AMR, (2) Safeguarding livestock and generating income source as primary motivators for using antimicrobials (3) Medicine shortage results in hoarding and self-prescribing, and (4) Farm decisions on AMU and livestock management influenced by foreign farmers and veterinarians. Livestock farmers used medicines in livestock production; however, they could not differentiate amongst different types of medicine, including antimicrobials. Antimicrobials were used to prevent diseases in livestock and promote production of food and financial security but without any awareness of the risks of AMR. Additionally, farmers hoarded and self-prescribed medicines. Farmers rationed antimicrobials by not completing the entire course of antibiotics to save them for future use. Based on past experiences, farmers expressed dissatisfaction with the veterinary services provided by the government. They sought help online and from foreign farmers and veterinarians. We propose the need for antimicrobial stewardship (AMS) programmes focused on promoting rational use of antimicrobials and awareness of AMR amongst farmers in the Fijian livestock production systems. These programmes need to consider the anthropological, socio-cultural, economic, and environmental factors driving AMU. Future studies are underway to explore the attitude and knowledge of Fijian veterinarians, para-veterinarians and pharmacists on AMU and AMR to gain a broader systems knowledge to inform the design of AMS programmes.
Collapse
Affiliation(s)
- Xavier Khan
- Department of Animal Sciences, School of Agriculture, Policy and Development, University of Reading, Reading, United Kingdom
| | - Rosemary H. M. Lim
- Reading School of Pharmacy, School of Chemistry, Food and Pharmacy, University of Reading, Whiteknights, Reading, United Kingdom
- *Correspondence: Rosemary H. M. Lim
| | - Caroline Rymer
- Department of Animal Sciences, School of Agriculture, Policy and Development, University of Reading, Reading, United Kingdom
| | - Partha Ray
- Department of Animal Sciences, School of Agriculture, Policy and Development, University of Reading, Reading, United Kingdom
- The Nature Conservancy, Arlington, VA, United States
| |
Collapse
|
6
|
Widayanti AW, Green JA, Heydon S, Norris P. Health-Seeking Behavior of People in Indonesia: A Narrative Review. J Epidemiol Glob Health 2021; 10:6-15. [PMID: 32175705 PMCID: PMC7310809 DOI: 10.2991/jegh.k.200102.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 12/21/2019] [Indexed: 11/01/2022] Open
Abstract
This review aims to locate existing studies on health-seeking behavior of people in Indonesia, identify gaps, and highlight important findings. Articles were retrieved from Medline, Scopus, Web of Science, Academic Search Complete (via Ebsco), and ProQuest with a number of key words and various combinations. Articles from Indonesian journals were also searched for with Google Scholar. A total of 56 articles from peer-reviewed journal databases and 19 articles from Indonesian journals were reviewed. Quantitative designs were applied more frequently than qualitative, and mixed methods designs were used in some studies. The majority gathered retrospective information about people's behaviors. Communicable diseases and maternity care were the most frequently studied conditions, in contrast to noncommunicable diseases. In terms of geographical distribution, most research was conducted on Java island, with very few in outside Java. Important findings are a model of Indonesian care-seeking pathways, an understanding of determinants of people's care choices, and the role of sociocultural beliefs. The findings from this narrative review provide insight to what and how Indonesians make decisions to manage their illness and why. This makes an important contribution to understanding the problem of underutilization of medical services despite the government's extensive efforts to improve accessibility.
Collapse
Affiliation(s)
- Anna Wahyuni Widayanti
- School of Pharmacy, University of Otago, Dunedin, New Zealand.,Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - James A Green
- School of Pharmacy, University of Otago, Dunedin, New Zealand.,School of Allied Health and Physical Activity for Health, Health Research Institute (HRI), University of Limerick, Limerick, Ireland
| | - Susan Heydon
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Pauline Norris
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| |
Collapse
|
7
|
Wagner CE, Prentice JA, Saad-Roy CM, Yang L, Grenfell BT, Levin SA, Laxminarayan R. Economic and Behavioral Influencers of Vaccination and Antimicrobial Use. Front Public Health 2020; 8:614113. [PMID: 33409264 PMCID: PMC7779682 DOI: 10.3389/fpubh.2020.614113] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/01/2020] [Indexed: 01/07/2023] Open
Abstract
Despite vast improvements in global vaccination coverage during the last decade, there is a growing trend in vaccine hesitancy and/or refusal globally. This has implications for the acceptance and coverage of a potential vaccine against COVID-19. In the United States, the number of children exempt from vaccination for “philosophical belief-based” non-medical reasons increased in 12 of the 18 states that allowed this policy from 2009 to 2017 (1). Meanwhile, the overuse and misuse of antibiotics, especially in young children, have led to increasing rates of drug resistance that threaten our ability to treat infectious diseases. Vaccine hesitancy and antibiotic overuse exist side-by-side in the same population of young children, and it is unclear why one modality (antibiotics) is universally seen as safe and effective, while the other (vaccines) is seen as potentially hazardous by some. In this review, we consider the drivers shaping the use of vaccines and antibiotics in the context of three factors: individual incentives, risk perceptions, and social norms and group dynamics. We illustrate how these factors contribute to the societal and individual costs of vaccine underuse and antimicrobial overuse. Ultimately, we seek to understand these factors that are at the nexus of infectious disease epidemiology and social science to inform policy-making.
Collapse
Affiliation(s)
- Caroline E Wagner
- Department of Bioengineering, McGill University, Montreal, QC, Canada
| | - Joseph A Prentice
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States
| | - Chadi M Saad-Roy
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States.,Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ, United States
| | - Luojun Yang
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States
| | - Bryan T Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States.,Princeton School of Public and International Affairs, Princeton University, Princeton, NJ, United States.,Fogarty International Center, National Institutes of Health, Bethesda, MD, United States
| | - Simon A Levin
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States.,Princeton Environmental Institute, Princeton University, Princeton, NJ, United States
| | - Ramanan Laxminarayan
- Princeton Environmental Institute, Princeton University, Princeton, NJ, United States.,Center for Disease Dynamics, Economics & Policy, Washington, DC, United States
| |
Collapse
|
8
|
Fletcher-Miles H, Gammon J. A scoping review on the influential cognitive constructs informing public AMR behavior compliance and the attribution of personal responsibility. Am J Infect Control 2020; 48:1381-1386. [PMID: 32067811 DOI: 10.1016/j.ajic.2020.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/06/2020] [Accepted: 01/06/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Antibiotic resistance is a growing threat to public health. Despite various attempts at educating the public on antimicrobial resistance (AMR) and judicial antibiotic use, fallacies and misconceptions remain. To successfully promote behavior change, various cognitive constructs pertaining to antibiotic behavior need to be identified and targeted. METHODS Using the Arksey and O'Malley (2005) methodological framework, a credible reflexive examination of literature was conducted, permitting identification of a breadth of literature that pertained to the influence of cognitive constructs on public antimicrobial behavior. RESULTS From 393 abstracts identified, 67 full articles were screened, and 43 papers were chosen for review. Three themes were identified (1) sociodemographic influences; (2) knowledge, misconceptions, and fallacies; and (3) public attitudes and the social influence of friends and family. Geographical location, education level, cognitive dissonance, and social norms were found to influence AMR cognition, resulting in disproportionate risk assessments that are facilitated by social information brokering. CONCLUSIONS Public AMR resilience, responsibility, and behavior compliance are influenced by cognitive constructs, which are liable to the appropriation of misconceptions, fallacies, and social behavior models obtained via information brokering. A cohesive multidisciplinary participatory approach to AMR management and interventional design that applies the influence of cognitive constructs to inform public AMR behavior compliance is recommended.
Collapse
Affiliation(s)
- Hayley Fletcher-Miles
- College of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom.
| | - John Gammon
- College of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom
| |
Collapse
|
9
|
Pratiwi W, Handayani TP. Antibiotic self‐medication among non‐medical practitioners in Cirebon city, Indonesia. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2020. [DOI: 10.1111/jphs.12336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Witri Pratiwi
- Department of Community Medicine and Public Health Faculty of Medicine Universitas Swadaya Gunung Jati Cirebon Indonesia
| | | |
Collapse
|
10
|
Tackling antimicrobial resistance in Bangladesh: A scoping review of policy and practice in human, animal and environment sectors. PLoS One 2020; 15:e0227947. [PMID: 31986167 PMCID: PMC6984725 DOI: 10.1371/journal.pone.0227947] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 01/04/2020] [Indexed: 11/29/2022] Open
Abstract
Background Antimicrobial resistance (AMR) has become an emerging issue in the developing countries as well as in Bangladesh. AMR is aggravated by irrational use of antimicrobials in a largely unregulated pluralistic health system. This review presents a ‘snap shot’ of the current situation including existing policies and practices to address AMR, and the challenges and barriers associated with their implementation. Methods A systematic approach was adopted for identifying, screening, and selecting relevant literature on AMR situation in Bangladesh. We used Google Scholar, Pubmed, and Biomed Central databases for searching peer-reviewed literature in human, animal and environment sectors during January 2010-August 2019, and Google for grey materials from the institutional and journal websites. Two members of the study team independently reviewed these documents for inclusion in the analysis. We used a ‘mixed studies review’ method for synthesizing evidences from different studies. Result Of the final 47 articles, 35 were primary research, nine laboratory-based research, two review papers and one situation analysis report. Nineteen articles on human health dealt with prescribing and/or use of antimicrobials, five on self-medication, two on non-compliance of dosage, and 10 on the sensitivity and resistance patterns of antibiotics. Four papers focused on the use of antimicrobials in food animals and seven on environmental contamination. Findings reveal widespread availability of antimicrobials without prescription in the country including rise in its irrational use across sectors and consequent contamination of environment and spread of resistance. The development and transmission of AMR is deep-rooted in various supply and demand side factors. Implementation of existing policies and strategies remains a challenge due to poor awareness, inadequate resources and absence of national surveillance. Conclusion AMR is a multi-dimensional problem involving different sectors, disciplines and stakeholders requiring a One Health comprehensive approach for containment.
Collapse
|
11
|
Irawati L, Alrasheedy AA, Hassali MA, Saleem F. Low-income community knowledge, attitudes and perceptions regarding antibiotics and antibiotic resistance in Jelutong District, Penang, Malaysia: a qualitative study. BMC Public Health 2019; 19:1292. [PMID: 31615486 PMCID: PMC6794866 DOI: 10.1186/s12889-019-7718-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 09/30/2019] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Understanding community perspectives on antibiotics and antibiotic resistance (ABR) is a key component in designing educational interventions to combat ABR at the community level in Malaysia. Therefore, this study aimed to explore community residents' knowledge, attitudes and perceptions regarding antibiotics and ABR in Jelutong District, Penang, Malaysia. Moreover, it intended to identify areas of focus to be addressed when designing an educational intervention to increase residents' knowledge and change their attitudes and perceptions. METHODS A qualitative approach was adopted to gain a deeper understanding of community residents' knowledge, attitudes and perceptions regarding antibiotics and ABR. A purposive sampling was employed. Twenty-two residents (aged ≥18 years) were interviewed with the aid of a semi-structured interview guide. All interviews were audio recorded, transcribed verbatim and thematically analysed. RESULTS The majority of the participants asserted that antibiotics could be effective against viral infections. Moreover, many participants were unaware that antibiotics have adverse effects. Some acquired antibiotics from a community pharmacy without a prescription, took antibiotics given to them by their family or friends, or took leftover antibiotics prescribed for a previous illness. A few indicated that they would request antibiotics from their physician when they had viral infections. More than half of the participants discontinued taking antibiotics when their symptoms improved. The majority stated that ABR occurs when the body becomes used to antibiotics. Most participants were unaware of the causes, consequences and prevention of ABR. In fact, they were not concerned about it. As a result, only a few perceived themselves as having responsibility for preventing this problem. CONCLUSIONS The community residents had misconceptions about antibiotics and ABR, negative attitudes towards antibiotics and negative perceptions of ABR. The areas of focus that need to be addressed when designing an educational intervention to increase the general public knowledge and change their attitudes and perceptions are the appropriate use of antibiotics and their adverse effects; the importance of adhering to antibiotic therapy; and the definition, causes, consequences and prevention of ABR.
Collapse
Affiliation(s)
- Lyna Irawati
- Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Alian A. Alrasheedy
- Unaizah College of Pharmacy, Qassim University, Buraydah, Qassim Saudi Arabia
| | | | - Fahad Saleem
- Faculty of Pharmacy and Health Sciences, University of Balochistan, Quetta, Pakistan
| |
Collapse
|
12
|
Tshokey T, Adhikari D, Tshering T, Wangmo S, Wangdi K. Assessing the Knowledge, Attitudes, and Practices on Antibiotics Among the General Public Attending the Outpatient Pharmacy Units of Hospitals in Bhutan: A Cross-Sectional Survey. Asia Pac J Public Health 2017; 29:580-588. [PMID: 28990398 DOI: 10.1177/1010539517734682] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We assessed the level of knowledge, attitudes, and practices on antibiotics through a questionnaire-based cross-sectional survey among the general public in Bhutan. Of the 692 participants, 52.6% (364) were females with a mean age of 34.2 years. More than half of the respondents showed unsatisfactory knowledge varying significantly from 23.1% to 69.6%. Cotrimoxazole (septran) was the least known while amoxicillin was the most known antibiotics assessed. Two-thirds of the responsents (267) knew that inappropriate use of antibiotics could lead to antimicrobial resistance and 89% (319) were aware of the need to complete the antibiotic courses. In bivariate analysis, satisfactory knowledge was associated with the education level of graduate and higher as compared with no education. This study revealed unsatisfactory knowledge and attitude but satisfactory practices on antibiotics use among participants. Efforts are needed to improve public awareness on antibiotics. Enforcement of regulations on sale of antibiotics over the counter needs a revamp.
Collapse
Affiliation(s)
- Tshokey Tshokey
- 1 Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Deepika Adhikari
- 2 Essential Medicine and Technology Division (EMTD), Ministry of Health, Thimphu, Bhutan
| | - Thupten Tshering
- 1 Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Sangay Wangmo
- 1 Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | | |
Collapse
|
13
|
Setiawan A, Dawson A. Strengthening the primary care workforce to deliver community case management for child health in rural Indonesia. AUST HEALTH REV 2017; 42:536-541. [PMID: 28965537 DOI: 10.1071/ah17092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 09/04/2017] [Indexed: 11/23/2022]
Abstract
Objectives The aim of the present study was to report on the implementation of community case management (CCM) to reduce infant mortality in a rural district, namely Kutai Timur, Kalimantan Indonesia. Methods An interpretive qualitative methodology was used. In-depth interviews were conducted with 18 primary healthcare workers (PHCWs), and PHCWs were observed during a consultation with mothers to gain insight into the delivery of the new protocol and workforce issues. The field notes and interview transcripts were analysed thematically. Results PHCWs reported that their performance had improved as a result of increased knowledge and confidence. The implementation of CCM had also reportedly enhanced the PHCWs' clinical reasoning. However, the participants noted confusion surrounding their role in prescribing medication. Conclusions CCM is viewed as a useful model of care in terms of enhancing the capacity of rural PHCWs to provide child health care and improve the uptake of life-saving interventions. However, work is needed to strengthen the workforce and to fully integrate CCM into maternal and child health service delivery across Indonesia. What is known about the topic? Indonesia has successfully reduced infant mortality in the past 10 years. However, concerns remain regarding issues related to disparities between districts. The number of infant deaths in rural areas tends to be staggeringly high compared with that in the cities. One of the causes is inadequate access to child health care. What does this paper add? CCM is a model of care that is designed to address childhood illnesses in limited-resource settings. In CCM, PHCWs are trained to deliver life-saving interventions to sick children in rural communities. In the present study, CCM improved the capacity of PHCWs to treat childhood illnesses. What are the implications for practitioners? CCM can be considered to strengthen PHCWs' competence in addressing infant mortality in areas where access to child health care is challenging. Policy regarding task shifting needs to be examined further so that CCM can be integrated into current health service delivery in Indonesia.
Collapse
Affiliation(s)
- Agus Setiawan
- Department of Community Health Nursing, Faculty of Nursing, Universitas Indonesia, Kampus Universitas Indonesia Depok, West Java 16424, Indonesia
| | - Angela Dawson
- The Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology, Sydney, 15 Broadway Ultimo NSW 2007, Australia. Email
| |
Collapse
|
14
|
Self-medication among the elderly in Iran: a content analysis study. BMC Geriatr 2017; 17:198. [PMID: 28863775 PMCID: PMC5580436 DOI: 10.1186/s12877-017-0596-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 08/22/2017] [Indexed: 12/03/2022] Open
Abstract
Background Self-medication is described as the use of drugs without a physician’s prescription to treat self-recognized illness or symptoms, and an important health issue among the elderly. Despite the wide range of different definitions, recognizing all forms of self-medication among older adults, particularly, in developing countries, help healthcare professionals and providers to reduce harmful effects of self-medication. The purpose of this study is to describe the practice of self-medication and its related factors among elderly people in Iran based on the experiences of people who are involved in this phenomenon. Methods This qualitative study was conducted using content analysis. Purposive sampling was used to select the participants and continued until saturation. The participants were the elderly, their care-givers, physicians, and pharmacists. Data was collected using semi-structured interviews, and analysis was done using an inductive approach. The theory of planned behavior was used as a framework to explain the role of the emerged factors in the occurrence of self-medication behavior. Results Based on the expressed experiences of the participants, factors related to the practice of self- medication among the elderly in Iran fit in these 5 categories: “patient’s attitudes towards disease, treatment, and physicians”, “living with disease”, “unfriendly environments”, “enabling health system”, and “influential others”. Conclusions Based on the results of this study, self-medication of the elderly in Iran has commonalities with many countries in regard to over-the-counter medications and complementary and alternative medicine; however, self-medication is also seen with drugs that require a prescription but can easily be obtained from pharmacies. Contributing factors, apart from the elderly themselves, include their families, caregivers, and social circle, the physical environment where they live, and the health system from which they receive services.
Collapse
|
15
|
Lapierre L, Asenjo G, Vergara C, Cornejo J. Antimicrobial Resistance Control Strategies: A Coordinated Research Initiative Experience in the Asia Pacific Region. Asia Pac J Public Health 2017; 29:250-258. [PMID: 28569113 DOI: 10.1177/1010539517709026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective was to gather information on the status of antimicrobial surveillance in the Asia Pacific region and suggest control strategies. Twenty-one economies of the Asia Pacific region participated in this initiative. A survey was conducted on antimicrobial use and surveillance throughout the region. A workshop was carried out to create awareness about the issue and discuss the implementation of control strategies. Based on the survey results and workshop conclusions, it can be established that there is better understanding of the implications of antimicrobial resistance in the human medicine area. Only few economies take actions to control antimicrobial resistance on a veterinary/agricultural level. To confront antimicrobial resistance, it is critical to raise awareness; cooperation between all countries is needed to apply international standards, to be able to have harmonized public policies. Countries must align and improve their systems for surveillance and monitoring of antimicrobial resistance in human, animals, and the environment.
Collapse
Affiliation(s)
- Lisette Lapierre
- 1 Faculty of Veterinary and Animal Sciences (FAVET), University of Chile, Santiago, Chile
| | - Gabriela Asenjo
- 1 Faculty of Veterinary and Animal Sciences (FAVET), University of Chile, Santiago, Chile
| | - Constanza Vergara
- 2 The Chilean Food Quality and Safety Agency (ACHIPIA), Ministry of Agriculture, Santiago, Chile
| | - Javiera Cornejo
- 1 Faculty of Veterinary and Animal Sciences (FAVET), University of Chile, Santiago, Chile
| |
Collapse
|
16
|
Harakeh S, Almatrafi M, Ungapen H, Hammad R, Olayan F, Hakim R, Ayoub M, Bakhsh N, Almasaudi SB, Barbour E, Bahijri S, Azhar E, Damanhouri G, Qari Y, Kumosani T, Harakeh Z, Ahmad MS, Cals JWL, Cals JL. Perceptions of medical students towards antibiotic prescribing for upper respiratory tract infections in Saudi Arabia. BMJ Open Respir Res 2015; 2:e000078. [PMID: 26175907 PMCID: PMC4488607 DOI: 10.1136/bmjresp-2014-000078] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 04/20/2015] [Accepted: 04/21/2015] [Indexed: 11/12/2022] Open
Abstract
Introduction This survey evaluates knowledge, attitudes and practices of medical students towards use of antibiotics for upper respiratory infections (URTIs). Methodology Cross-sectional questionnaire study among 1042 randomly selected medical students in Saudi Arabia. Results Respondents were mostly Saudis (97.5%), had previous knowledge of antibiotics (99.7%) and their usage (98.3%) against bacterial infections (93.7%). 18.1% thought that they could be used for viral infections. Nearly all students (97.2%) used antibiotics themselves during the previous year and self-medication without a prescription was high at 49% of cases. Most antibiotics were taken for URTI symptoms (61.8%). Female medical students had better knowledge on antibiotic effectiveness against bacteria and viruses, and overall knowledge increased with study year. Health seeking behaviour rates for symptoms of RTI and associated estimated necessity for antibiotics varied but were highest for cough with yellow/green phlegm. Conclusions The depth of knowledge that healthcare professionals have in relation to the proper use of antibiotics is essential in spreading the right message within communities. This is the first large study among medical students in Saudi Arabia, shedding important light on areas for improvement in the medical curriculum as well as antibiotic practices of medical students themselves.
Collapse
Affiliation(s)
- Steve Harakeh
- Special Infectious Agents Unit , King Fahd Medical Research Center, King Abdulaziz University , Jeddah , Saudi Arabia
| | - Musab Almatrafi
- Obstetrics and Gynecology Department, King Abdulaziz Medical City, National Guard Health Affair, Riyadh , Saudi Arabia
| | | | - Rotana Hammad
- Department of Pediatric , King Fahad Armed Forces Hospital , Jeddah , Saudi Arabia
| | - Feras Olayan
- Medical School, Umm Alqura University, Makkah , Saudi Arabia
| | - Reema Hakim
- Department of Family Medicine, National Guard Hospital , Jeddah , Saudi Arabia
| | - Mohammed Ayoub
- Department of Pediatric, National Guard Hospital, Jeddah, Saudi Arabia
| | - Noura Bakhsh
- Medical School, Umm Alqura University, Makkah , Saudi Arabia
| | - Saad B Almasaudi
- Biology Department, King Abdulaziz University , Jeddah , Saudi Arabia
| | - Elie Barbour
- Department of Animal and Veterinary Sciences, American University of Beirut, Lebanon; Adjunct to Biochemistry Department, Faculty of Science and Production of Bioproducts for Industrial Application Research Group, King Abdulaziz Univeristy, Jeddah , Saudi Arabia
| | - Suhad Bahijri
- King Fahd Medical Research Center , Jeddah , Saudi Arabia
| | - Esam Azhar
- Special Infectious Agents Unit , King Fahd Medical Research Center, King Abdulaziz University , Jeddah , Saudi Arabia
| | | | - Yousef Qari
- Department of Gastroenterology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Taha Kumosani
- Biochemistry Department, Faculty of Science and Experimental Biochemistry Unit, King Fahd Medical Research Center , Jeddah , Saudi Arabia
| | - Zeena Harakeh
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Muhammad S Ahmad
- Drug Metabolism Unit, King Fahd Medical Research Center, Jeddah, Saudi Arabia
| | | | - JochenW L Cals
- Department of Family Medicine, School of Primary Care and Public Health (CAPHRI), Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
17
|
Arparsrithongsagul S, Kulsomboon V, Zuckerman IH. Multidisciplinary Perspective Intervention With Community Involvement to Decrease Antibiotic Sales in Village Groceries in Thailand. Asia Pac J Public Health 2013; 27:NP2480-8. [DOI: 10.1177/1010539513479968] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In Thailand, antibiotics are rampantly available in village groceries, despite the fact that it is illegal to sell antibiotics without a pharmacy license. This study implemented a multidisciplinary perspectives intervention with community involvement (MPI&CI), which was developed based on information obtained from focus groups that included multidisciplinary stakeholders. Community leaders in the intervention group were trained to implement MPI&CI in their villages. A quasi-experiment with a pretest–posttest design was conducted. Data were collected from 20 villages in Mahasarakham Province (intervention group) along with another 20 villages (comparison group). Using a generalized linear mixed model Poisson regression with repeated measures, groceries in the intervention group had 87% fewer antibiotics available at postintervention compared with preintervention (relative rate = 0.13; 95% confidence interval = 0.07-0.23), whereas the control group had only an 8% reduction in antibiotic availability (relative rate = 0.92; 95% confidence interval = 0.88-0.97) between the 2 time periods. Further study should be made to assess the sustainability and long-term effectiveness of MPI&CI.
Collapse
|