Dispensing of Non-Prescribed Antibiotics from Community Pharmacies of Pakistan: A Cross-Sectional Survey of Pharmacy Staff’s Opinion
Abstract
:1. Introduction
2. Results
2.1. Participant Demographics
2.2. Knowledge and Attitudes about DoNA
2.3. Practices of DoNA
2.4. Suggestions to Stop DoNA
3. Discussion
4. Methods
4.1. Study Setting
4.2. Sampling and Pharmacy Selection
4.3. Participant Inclusion Criteria
4.4. Study Instrument
4.5. Pilot Study
4.6. Data Collection
4.7. Data Analysis
4.8. Ethics Approval
5. Conclusions
6. Limitations
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Range/Groups | Frequency (%) |
---|---|---|
Age (Years) | 30 or below | 159 (27.7) |
31–40 | 252 (44.0) | |
41–50 | 137 (23.9) | |
51 or above | 25 (4.4) | |
Mean age ± SD = 34.9 ± 2.6 | ||
Gender | Male | 573 (100.0) |
Female | 0 (0.0) | |
Education | Formal education | 467 (81.5) |
Professional education | 106 (18.5) | |
Experience (Years) | 5–10 | 279 (48.7) |
11–15 | 222 (38.7) | |
More than 15 | 72 (12.6) | |
Status in pharmacy | Employee | 294 (51.3) |
Manager | 41 (7.2) | |
Proprietor | 238 (41.5) | |
Prescriptions (all types of medicines) per day | Less or 50 | 314 (54.8) |
51–100 | 176 (30.7) | |
More than 100 | 83 (14.5) | |
Total antibiotics dispensed per day(Prescribed + Non prescribed) | Less or 20 | 287 (50.1) |
21–40 | 197 (34.4) | |
More than 40 | 89 (15.5) | |
DoNA per day | Less or 10 | 273 (47.7) |
11–20 | 199 (34.7) | |
More than 20 | 101 (17.6) |
Measures | Yes n (%) | No n (%) | Don’t Know n (%) |
---|---|---|---|
Community pharmacies in Pakistan are authorized for DoNA | 293 (51.1) | 109 (19.1) | 171(29.8) |
DoNA from community pharmacies of Pakistan is common practice | 467 (81.5) | 22(3.8) | 84(14.7) |
Dispensing of PoM without prescription causes health issues | 212 (37.0) | 289 (50.4) | 72(12.6) |
DoNA contributes to the development of AMR | 397 (69.3) | 128 (22.3) | 48(8.4) |
AMR has become a challenging issue of public health | 299 (52.2) | 115 (20.1) | 159(27.7) |
DoNA is a cause of irrational use of antibiotics by patients | 453 (79.1) | 104 (18.1) | 16(2.8) |
Pharmacy retailers should stop DoNA | 318 (55.5) | 222 (38.7) | 33(5.8) |
I recommend doctor’s consultation to the patients before use of any antibiotic | 198 (34.5) | 375 (65.4) | __________ * |
On my refusal to DoNA, patient will try to get antibiotics from another pharmacy | 503 (87.8) | 62(10.8) | 8(1.4) |
DoNA reduces the economic burden of patients | 354 (61.8) | 88 (15.4) | 131(22.8) |
Measures | Items | Frequency (%) |
---|---|---|
Reasons for DoNA | Pharmacy retailers have proper knowledge about use of antibiotics | 257 (44.9) |
Patients visit physicians only for serious infections | 317 (55.3) | |
Increases the profit and sales | 97 (16.9) | |
Lack of patients’ affordability for consultation fee of doctors | 366 (63.9) | |
Fear of customer loss | 93 (16.2) | |
Unawareness of pharmacy staff toward policy and regulations | 107 (18.7) | |
Classes of commonly dispensed non prescribed antibiotic | Nitroimidazole | 411 (71.7) |
Penicillins | 382 (66.7) | |
Quinolones | 337 (58.8) | |
Cephalosporins | 207 (36.1) | |
Tetracycline | 116 (20.2) | |
Macrolides | 91 (15.9) | |
Administration form of commonly dispensed non prescribed antibiotic | Oral | 462 (80.6) |
Topical cream/ointment | 294 (51.3) | |
Ophthalmic ointment/drops | 271 (47.3) | |
Ear drops | 211 (36.8) | |
Parenteral/Injectables | 17 (2.9) |
Measures | Score | p-Values | |
---|---|---|---|
Mean ± SD | Age | Education | |
Before DoNA, I inquire thedrug allergies to patients | 3.7 ± 0.10 | 0.050 | 0.572 |
Before DoNA, I inquire about the renal condition of patients | 2.5 ± 0.06 | 0.048 | 0.162 |
Before DoNA, I ask the patient about other disease/s or therapies | 4.9 ± 0.13 | 0.573 | 0.201 |
At the time of DoNA, I inform the patients about possible side effects | 3.0 ± 0.08 | 0.047 | 0.411 |
At the time of DoNA, I counsel the patients for medication adherence and compliance | 5.2 ± 0.14 | 0.172 | 0.070 |
I don’t dispense non-prescribed antibiotics for children | 2.7 ± 0.07 | 0.701 | 0.090 |
I don’t dispense non-prescribed antibiotics for pregnant women | 3.0 ± 0.08 | 0.849 | 0.385 |
Measures | Items | Frequency (%) |
---|---|---|
To control DoNA from community pharmacies | Pharmacy retailers should penalized | 92 (16.1) |
Vigilance of pharmacies by drug inspectors should be more strong | 78 (13.6) | |
Pharmacy retailers need continuous trainings | 397 (69.2) | |
Other e.g., reduction ofdoctors’ consultation fee, increase in free health facilities | 17 (2.9) | |
Role of pharmacy retailers to halt DoNA | Educate patients about the outcome and AMR due DoNA | 458 (79.9) |
Educate and train the staff of pharmacy about the outcome and AMR due DoNA | 347 (60.6) | |
Arranging awareness seminars in Chemist and Druggist Associations’ meetings | 272 (47.5) | |
Arrange public awareness campaigns | 167 (29.1) |
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Majid Aziz, M.; Haider, F.; Rasool, M.F.; Hashmi, F.K.; Bahsir, S.; Li, P.; Zhao, M.; Alshammary, T.M.; Fang, Y. Dispensing of Non-Prescribed Antibiotics from Community Pharmacies of Pakistan: A Cross-Sectional Survey of Pharmacy Staff’s Opinion. Antibiotics 2021, 10, 482. https://doi.org/10.3390/antibiotics10050482
Majid Aziz M, Haider F, Rasool MF, Hashmi FK, Bahsir S, Li P, Zhao M, Alshammary TM, Fang Y. Dispensing of Non-Prescribed Antibiotics from Community Pharmacies of Pakistan: A Cross-Sectional Survey of Pharmacy Staff’s Opinion. Antibiotics. 2021; 10(5):482. https://doi.org/10.3390/antibiotics10050482
Chicago/Turabian StyleMajid Aziz, Muhammad, Fatima Haider, Muhammad Fawad Rasool, Furqan Khurshid Hashmi, Sadia Bahsir, Pengchao Li, Mingyue Zhao, Thamir M. Alshammary, and Yu Fang. 2021. "Dispensing of Non-Prescribed Antibiotics from Community Pharmacies of Pakistan: A Cross-Sectional Survey of Pharmacy Staff’s Opinion" Antibiotics 10, no. 5: 482. https://doi.org/10.3390/antibiotics10050482
APA StyleMajid Aziz, M., Haider, F., Rasool, M. F., Hashmi, F. K., Bahsir, S., Li, P., Zhao, M., Alshammary, T. M., & Fang, Y. (2021). Dispensing of Non-Prescribed Antibiotics from Community Pharmacies of Pakistan: A Cross-Sectional Survey of Pharmacy Staff’s Opinion. Antibiotics, 10(5), 482. https://doi.org/10.3390/antibiotics10050482