Knowledge, attitudes, perceptions and habits towards antibiotics dispensed without medical prescription: a qualitative study of Spanish pharmacists

Abstract

ObjectiveTo investigate community pharmacists’ knowledge, attitudes, perceptions and habits with regard to antibiotic dispensing without medical prescription in Spain.MethodsA qualitative research using focus group method (FG) in Galicia (north-west Spain). FG sessions were conducted in the presence of a moderator. A topic script was developed to lead the discussions, which were audiorecorded to facilitate data interpretation and transcription. Proceedings were transcribed by an independent researcher and interpreted by two researchers working independently. We used the Grounded Theory approach.SettingCommunity pharmacies in Galicia, region Norwest of Spain.ParticipantsThirty pharmacists agreed to participate in the study, and a total of five FG sessions were conducted with 2–11 pharmacists. We sought to ensure a high degree of heterogeneity in the composition of the groups to improve our study’s external validity. Pharmacists’ participation had no gender or age restrictions, and an effort was made to form FGs with pharmacists who were both owners and non-owners, provided in all cases that they were Official Colleges of Pharmacists-registered community pharmacists. For the purpose of conducting FG discussions, the basic methodological principle of allowing groups to attain their ‘own structural identity’ was applied.Main outcome measurementsCommunity pharmacists’ habits and knowledge with regard to antibiotics and identification of the attitudes and/or factors that influence antibiotic dispensing without medical prescription.ResultsPharmacists attributed the problem of antibiotics dispensed without medical prescription and its relationship to antibiotic resistance to the following attitudes: external responsibility (doctors, dentists and the National Health Service (NHS)); acquiescence; indifference and lack of continuing education.ConclusionsDespite being a problem, antibiotic dispensing without a medical prescription is still a common practice in community pharmacies in Galicia, Spain. This practice is attributed to acquiescence, indifference and lack of continuing education. The problem of resistance was ascribed to external responsibility, including that of patients, physicians, dentists and the NHS.

Knowledge, Attitude and Practice of Community Pharmacists Regarding Antibiotic Use and Infectious Diseases: A Cross-Sectional Survey in Hungary (KAPPhA-HU)

“…Non-prescription (OTC) AB use and antibiotic self-medication (SMA) is one of the main factors in the irrational use of ABs and the development of MDR bacteria, so controlling AB use may present as a viable means of intervention [36][37][38]. Our results (e.g., 26% of the interviewed had dispensed non-prescribed ABs) are comparable with those found by Vazquez-Lago et al, as they found that 5%-20% of the pharmacists dispensed non-prescribed ABs [39]. A very similar proportion of the Albanian pharmacists, 89%, thought that ABs should not be given out without a prescription [35].…”

“…The main reasons for the malpractice of non-prescription AB-dispensing were summarized by Vazquez-Lago et al [39]: the study group had defined reasons such as economic/patient-specific (a.: pressure from patients to have their complaints rapidly resolved; b.: fear of losing loyal customers, especially in smaller towns; c.: fear of rejection by common people with not meet expectations; and d.: pressures from pharmacy owners), internal/pharmacist-specific (bad habits during dispensing and a lack of continuous professional development) and external (indifference of physicians regarding patient follow-up, a lack of communication, no enforcement on the part of the authorities). These findings have been reinforced by several other publications [33][34][35][36][37][38][40][41][42].…”

Knowledge, attitude, and practices of community pharmacy staff toward antimicrobial stewardship programs: a cross-sectional study from Northeastern China

“…Most of the survey participants agreed that antimicrobials might cause AMR and allergic reactions, but they ignored the risk of increasing treatment costs. A large number of studies have already shown that the community pharmacy staff's knowledge of antimicrobials is good, but the perception of the cost of antimicrobials and practices toward ASP was poor [21,[29][30][31][32]. We found that the participants' most common source of knowledge about antimicrobials was pharmacy training, which indicates that pharmacy training systems in China have improved in recent years.…”

The Knowledge, Attitudes, and Practices of Community Pharmacists in their Approach to Antibiotic Use: A Nationwide Survey in Italy

“…Several investigations in different countries have assessed the knowledge, attitudes, and behavior of the general population and physicians regarding antibiotic use [10][11][12][13][14][15]; however, relatively few have been conducted among pharmacists [16][17][18]. To date, there is a general paucity of information in the literature on this topic among Italian community pharmacists.…”