Factors determining antibiotic use in the general population: A qualitative study in Spain

Abstract

Background Antibiotic resistance is an important Public Health problem and many studies link it to antibiotic misuse. The population plays a key role in such misuse. Objective The aim of this study was thus to explore the factors that might influence antibiotic use and resistance in the general population. Methods Qualitative research using the focus group (FG) method. Groups were formed by reference to the following criteria: age (over and under 65 years); place of origin; and educational/professional qualifications. FG sessions were recorded, transcribed and then separately analysed by two researchers working independently. Written informed consent was obtained from all participants. Results Eleven FGs were formed with a total of 75 participants. The principal factors identified as possible determinants of antibiotic misuse were: (i) lack of knowledge about antibiotics; (ii) doctor-patient relationship problems; (iii) problems of adherence; and, (iv) use without medical prescription. Antibiotic resistance is a phenomenon unknown to the population and is perceived as an individual problem, with the term “resistance” being confused with “tolerance”. None of the groups reported that information about resistance had been disseminated by the health care sector. Conclusions The public is unaware of the important role it plays in the advance of antimicrobial resistance. There is evidence of diverse factors, many of them modifiable, which might account for antibiotic misuse. Better understanding these factors could be useful in drawing up specific strategies aimed at improving antibiotic use.

Socio-cultural determinants of antibiotic resistance: a qualitative study of Greeks’ attitudes, perceptions and values

“…Some comparisons can be made with similar studies performed in other countries with relatively high rates of antibiotic use and antibiotic resistance in the WHO European region [49]. The centrality of trust in health professionals and health institutions as a factor promoting a judicious use of antibiotics -and conversely, lack of trust as a hindering factor -was emphasized by recent research on the Spanish, Turkish, and French public [50][51][52]. In contrast to the findings of the present study, participants in focus groups in Spain showed a relative lack of knowledge and a lack of perception of the problem of antibiotic resistance [50].…”

“…The centrality of trust in health professionals and health institutions as a factor promoting a judicious use of antibiotics -and conversely, lack of trust as a hindering factor -was emphasized by recent research on the Spanish, Turkish, and French public [50][51][52]. In contrast to the findings of the present study, participants in focus groups in Spain showed a relative lack of knowledge and a lack of perception of the problem of antibiotic resistance [50]. The normative role of individuals' social circle, mainly friends and families, was recognized also by Westerling et al [51].…”

Experiences of antibiotic use among Brazilian healthcare users: An exploratory study

“…Once the respondents effectively build a repertoire of experiences about antibiotics use and health issues, their expectation is that HPs will listen to and respond to these experiences 12,34 . Compliance with medical orientation, as the respondents' state, is linked to the trust they have in the doctor, paralleling recent research 30 . Thus, active listening to users' experiences can help HPs identify the specific contexts in which they make decisions on following or not medical instructions 10 …”

“…There may be a ‘grey area’ 28 in the communication between HPs and users, as neither seems to address differences between medications or their potential harm. 30 This ‘grey area’ may be a result of structural constraints, such as the limited time for sharing information between HPs and users 31 and the high demand for consultations at PCU, but it is also related to the feeling of trust users have regarding the quality of their relationship with HP during the consultation. The users' assessments will influence how their consideration of and degree of compliance with doctors' instructions.…”

Prevalence and reasons associated with antibiotics misuse and self-medication among adults in Nigeria: A systematic review and meta-analysis [Protocol]

“…4 While about 80%-90% of all antibiotics are used in the community, majority of those antibiotics are used without prescription by trained health personnel. 5 Developing countries account for greater proportion of antibiotics misuse and self-medication. 6 Studies have reported higher prevalence of antibiotics misuse and self-medication in developing countries compared with developed countries.…”