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Pei D, Kreps G, Zhao X. The Role of Uncertainty and Negative Emotion in Chinese Parents' Self-Medication of Children with Antibiotics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6603. [PMID: 37623186 PMCID: PMC10454897 DOI: 10.3390/ijerph20166603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/07/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
Parents self-medicating their children with antibiotics (SMA) without consulting healthcare professionals is a common practice in China. Previous research has focused primarily on examining the socioeconomic factors that contribute to the prevalence of SMA. This study adopts and extends the theory of planned behavior to understand the cognitive and emotional factors that are associated with parental SMA in China. The responses to an online survey were collected from 961 parents of children aged 6-12 years old, primarily from Gansu, Shandong, and Shaanxi provinces. More than half of the participants (66.5%) engaged in parental SMA. Amoxicillin, Cephradine, and Azithromycin were the most frequently selected antibiotics used for children. Structural equation modeling showed that uncertainty was positively associated with negative emotions, which were in turn positively associated with attitude toward SMA. Uncertainty was also negatively associated with perceived behavioral control (PBC), but the association between PBC and SMA behavior was not significant. Attitude and subjective norm were both positively associated with SMA behavior. The relationship between subjective norm and attitude was also positive. Understanding the psychological factors driving parental SMA may inform tailored interventions to promote responsible antibiotic use among parents.
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Affiliation(s)
- Di Pei
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA;
| | - Gary Kreps
- Department of Communication, George Mason University, Fairfax, VA 22030, USA
| | - Xiaoquan Zhao
- Department of Communication, George Mason University, Fairfax, VA 22030, USA
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Ngyedu EK, Acolatse J, Akafity G, Incoom R, Rauf A, Seaton RA, Sneddon J, Cameron E, Watson M, Wanat M, Godman B, Kurdi A. Selling antibiotics without prescriptions among community pharmacies and drug outlets: a simulated client study from Ghana. Expert Rev Anti Infect Ther 2023; 21:1373-1382. [PMID: 37975725 DOI: 10.1080/14787210.2023.2283037] [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: 05/15/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Selling antibiotics without prescriptions is mostly illegal worldwide, including in Ghana, and promotes antimicrobial resistance. We evaluated the prevalence and practice of selling antibiotics without prescriptions among community pharmacies (CPs) and drug outlets, for the first time, in Ghana to quantify and characterize this issue to inform future interventions. RESEARCH DESIGN AND METHODS Two scenarios utilizing the Simulated Client Methodology were enacted: an upper respiratory tract infection of viral origin (scenario one); and pediatric diarrhea (scenario two). CPs/Outlets were selected by stratified proportional random sampling from four metropolitan cities (~14% of the total Ghanaian population). Selling of antibiotics was assessed at three demand levels and its overall prevalence was estimated, then stratified by the study variables. RESULTS Out of the 265 sampled CPs/outlets, the prevalence of selling antibiotic without prescription was 88.3% (n = 234/265), with variations not only across the four regions [92.5% (n = 123/133) in Kumasi, 87.5% (n = 14/16) in Cape Coast, 84.1% (n = 69/82) in Accra, and 82.4% (n = 28/34) in Tamale] but also across CPs [90% (n = 121/134)] and drug outlets [86% (n = 113/131)]. CONCLUSIONS A very high prevalence/sub-optimal practice of selling antibiotics without prescriptions was found. This highlights the need to increase compliance with antibiotic dispensing legislation through evidence-based interventions including education of key stakeholders.
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Affiliation(s)
- Eric Kofi Ngyedu
- Oral and Maxillofacial Surgery, Research Unit, Cape Coast Teaching Hospital (CCTH), Cape Coast, Ghana
| | - Joseph Acolatse
- Oral and Maxillofacial Surgery, Research Unit, Cape Coast Teaching Hospital (CCTH), Cape Coast, Ghana
| | - George Akafity
- Oral and Maxillofacial Surgery, Research Unit, Cape Coast Teaching Hospital (CCTH), Cape Coast, Ghana
| | - Robert Incoom
- Oral and Maxillofacial Surgery, Research Unit, Cape Coast Teaching Hospital (CCTH), Cape Coast, Ghana
| | | | - R Andrew Seaton
- Department is Infectious Unit, Queen Elizabeth University Hospital, Glasgow, UK
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | | | - Elaine Cameron
- School of Psychology, University of Stirling, Stirling, UK
| | - Margaret Watson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UK
| | - Marta Wanat
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UK
- Department of Clinical Pharmacy, College of Pharmacy, Hawler Medical University, Erbil, Iraq
- Centre of Medical and Bio allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Amanj Kurdi
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UK
- Centre of Medical and Bio allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- College of Pharmacy, Al-Kitab University, Kirkuk, Iraq
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Basheti IA, Barqawi H, Nassar RI, Thiab S, Atatreh N, Abu-Gharbieh E. The Effects of Medications and the Roles of Pharmacists on the Recovery of Patients with COVID-19 Infection: An Epidemiological Study from the United Arab Emirates. Healthcare (Basel) 2023; 11:healthcare11040467. [PMID: 36833001 PMCID: PMC9957395 DOI: 10.3390/healthcare11040467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
Patients infected with coronavirus have new experiences and hence new needs from the healthcare sector. Acknowledging patients' experiences can exhibit promising outcomes in coronavirus management. Pharmacists are considered a vital pillar in managing patients' experiences during their infection. A cross-sectional study was conducted to assess the experiences of COVID-19-infected individuals and the roles of pharmacists in the United Arab Emirates. The survey was face- and content-validated after being developed. Three sections were included in the survey (demographics, experiences of infected individuals, and the roles of pharmacists). Data were analyzed using the Statistical Package for the Social Sciences. The study participants (n = 509) had a mean age of 34.50 (SD = 11.93). The most reported symptoms among participants were fatigue (81.5%), fever (76.8%), headache (76.6%), dry cough (74.1%), muscle or joint pain (70.7%), and sore throat (68.6%). Vitamin C was the most used supplement (88.6%), followed by pain relievers (78.2%). Female gender was the only factor associated with symptom severity. About 79.0% agreed that the pharmacist played an important and effective role during their infection. The most reported symptom was fatigue, with females reporting more severe symptoms. The role of the pharmacist proved to be vital during this pandemic.
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Affiliation(s)
- Iman A. Basheti
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931, Jordan
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Camperdown, NSW 2006, Australia
- Correspondence: or ; Tel.: +962-6560-9999 (ext. 1510) or +962-79770-8060
| | - Hiba Barqawi
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Razan I. Nassar
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931, Jordan
| | - Samar Thiab
- Department of Pharmaceutical Chemistry and Pharmacognosy, Faculty of Pharmacy, Applied Science Private University, Amman 11931, Jordan
| | - Noor Atatreh
- College of Pharmacy, Al Ain University, Abu Dhabi 64141, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi 64141, United Arab Emirates
| | - Eman Abu-Gharbieh
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
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Schellack N, Strydom M, Pepper MS, Herd CL, Hendricks CL, Bronkhorst E, Meyer JC, Padayachee N, Bangalee V, Truter I, Ellero AA, Myaka T, Naidoo E, Godman B. Social Media and COVID-19—Perceptions and Public Deceptions of Ivermectin, Colchicine and Hydroxychloroquine: Lessons for Future Pandemics. Antibiotics (Basel) 2022; 11:antibiotics11040445. [PMID: 35453198 PMCID: PMC9031711 DOI: 10.3390/antibiotics11040445] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 02/04/2023] Open
Abstract
The capacity for social media to influence the utilization of re-purposed medicines to manage COVID-19, despite limited availability of safety and efficacy data, is a cause for concern within health care systems. This study sought to ascertain links between social media reports and utilization for three re-purposed medicines: hydroxychloroquine (HCQ), ivermectin and colchicine. A combined retrospective analysis of social media posts for these three re-purposed medicines was undertaken, along with utilization and clinical trials data, in South Africa, between January 2020 and June 2021. In total, 77,257 posts were collected across key social media platforms, of which 6884 were relevant. Ivermectin had the highest number of posts (55%) followed by HCQ (44%). The spike in ivermectin use was closely correlated to social media posts. Similarly, regarding chloroquine (as HCQ is not available in South Africa), social media interest was enhanced by local politicians. Sentiment analysis revealed that posts regarding the effectiveness of these repurposed medicines were positive. This was different for colchicine, which contributed only a small number of mentions (1%). Of concern is that the majority of reporters in social media (85%) were unidentifiable. This study provides evidence of social media as a driver of re-purposed medicines. Healthcare professionals have a key role in providing evidence-based advice especially with unidentifiable posts.
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Affiliation(s)
- Natalie Schellack
- Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South Africa; (M.S.); (A.A.E.); (T.M.); (E.N.)
- Correspondence: (N.S.); or (B.G.)
| | - Morné Strydom
- Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South Africa; (M.S.); (A.A.E.); (T.M.); (E.N.)
| | - Michael S. Pepper
- Institute for Cellular and Molecular Medicine, Department of Immunology and SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South Africa; (M.S.P.); (C.L.H.); (C.L.H.)
| | - Candice L. Herd
- Institute for Cellular and Molecular Medicine, Department of Immunology and SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South Africa; (M.S.P.); (C.L.H.); (C.L.H.)
| | - Candice Laverne Hendricks
- Institute for Cellular and Molecular Medicine, Department of Immunology and SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South Africa; (M.S.P.); (C.L.H.); (C.L.H.)
| | - Elmien Bronkhorst
- School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0084, South Africa; (E.B.); (J.C.M.)
| | - Johanna C. Meyer
- School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0084, South Africa; (E.B.); (J.C.M.)
| | - Neelaveni Padayachee
- Department of Pharmacy and Pharmacology, Faculty of Health Sciences, School of Therapeutic Sciences, University of Witwatersrand, Johannesburg 2050, South Africa;
| | - Varsha Bangalee
- Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa;
| | - Ilse Truter
- Drug Utilization Research Unit (DURU), Department of Pharmacy, Nelson Mandela University, Port Elizabeth 6031, South Africa;
| | - Andrea Antonio Ellero
- Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South Africa; (M.S.); (A.A.E.); (T.M.); (E.N.)
- Centre for Neuroendocrinology (CNE), Department of Immunology, University of Pretoria, Pretoria 0084, South Africa
| | - Thulisa Myaka
- Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South Africa; (M.S.); (A.A.E.); (T.M.); (E.N.)
| | - Elysha Naidoo
- Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South Africa; (M.S.); (A.A.E.); (T.M.); (E.N.)
| | - Brian Godman
- School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0084, South Africa; (E.B.); (J.C.M.)
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman P.O. Box 346, United Arab Emirates
- Correspondence: (N.S.); or (B.G.)
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Sefah IA, Mensah F, Kurdi A, Godman B. Barriers and facilitators of adherence to antiretroviral treatment at a public health facility in Ghana: a mixed method study. Hosp Pract (1995) 2022; 50:110-117. [PMID: 35189065 DOI: 10.1080/21548331.2022.2045132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND HIV/AIDS is a disease of global public health concern with high morbidity and mortality rates. Poor adherence to antiretroviral therapy (ART) increases the risk of viral drug resistance and reduces treatment effectiveness towards viral suppression leading to disease progression, greater risk of death and increased risk of viral transmission. The study sought to assess current adherence levels to ART among patients in Ghana, exploring barriers and enablers of adherence to it, to provide future guidance to all key stakeholder groups. METHOD A mixed method approach was used comprising of a cross-sectional survey of patients followed by a focused group discussion with patients and an in-depth interview of four key health professionals working in the ART clinic of Atua Government Hospital, a primary care health facility in the Eastern Region of Ghana. A structured questionnaire was used to assess current adherence levels and their determinants among 231 randomly selected patients attending the clinic between July to September, 2019. Quantitative data were analysed using bivariate and multivariate methods while qualitative data were analysed using thematic framework approach. RESULTS Adherence levels was found to be 42.9% among our study population. Lower adherence to ART was associated with patients' belief in herbal medicine (aOR =0.34 CI: 0.19-0.61). Other barriers identified from the qualitative analysis included low motivation arising from pill fatigue, forgetfulness, frequent stock out of medicines, long waiting times and worrying side-effects; while enablers, on the other hand, included measures that ensure improved assessment of adherence and health facility-related activities that improve patient satisfaction with ART services. Conclusion: Adherence to ART among patients living with HIV was sub-optimal in our study population. Understanding of the barriers and factors that enable adherence to ART is a key step to developing evidence-based adherence improvement strategies to enhance clinical outcomes.
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Affiliation(s)
- Israel Abebrese Sefah
- Pharmacy Practice Department, School of Pharmacy, University of Health and Allied Sciences, Volta Region, Ghana
| | - Frederick Mensah
- Pharmacy Department, Atua Government Hospital, Eastern Region, Ghana
| | - Amanj Kurdi
- Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil, Iraq.,Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, United Kingdom
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, United Kingdom.,School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, 0208, South Africa.,Centre of Medical and Bio-allied Health Sciences Research, Ajman University, United Arab Emirates
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