Patients’ Anticipation for the Pharmacies of Rural Communities: A Qualitative Study from Pakistan

Aziz, Muhammad Majid; Jiang, Minghuan; Masood, Imran; Chang, Jie; Zhu, Shaowei; Raza, Muhammad Ali; Ji, Wenjing; Yang, Caijun; Fang, Yu

doi:10.3390/ijerph16010143

Cited by 13 publications

(11 citation statements)

References 39 publications

(64 reference statements)

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“…The sample was limited to pharmacies in three cities in Pakistan. Further work should be conducted in rural parts which may differ in rates of pharmacist availability and client needs 23 . Quantitative studies with probability samples should complement findings from this study by monitoring the actual rates of adherence to the law in pharmacies.…”

Section: Discussionmentioning

confidence: 97%

Perspectives on an amended law addressing pharmacists' availability in community pharmacies

Qadeer

Amin

2020

Evaluation Clinical Practice

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Rationale, aims, and objectives Little attention has been given to perceptions of pharmacist availability and role in the community setting following policy changes. The Pakistani model is particularly interesting as it encompasses three different pharmacy practice licensure types with major differences in credentials, training, and role. Guided by the theory of planned behaviour (TPB), this study examined factors associated with the availability of pharmacists in the community setting in Pakistan following the implementation of a new policy regulating pharmacist presence in community pharmacies. Methods Fifteen participants were interviewed in three Pakistani cities (Islamabad, Lahore, and Peshawar). Those included pharmacy licence holders (types A, B, and C), non‐pharmacist owners and a pharmacist inspector who were purposively sampled to assure variance in education, gender, time in practice, and geographic location. Directed content analysis was performed based on the TPB framework. Description of themes came after discussions among the two authors. Results Findings indicated a discrepancy between participants about the value of having a pharmacist present with pharmacists showing more appreciation of the value they would provide. Participants felt that the new policy is attempting to change a norm that has existed for a long time. They also pointed to logistical challenges in making a pharmacist available including the feasibility of having a pharmacist present, the financial burden of hiring a pharmacist, and difficulty in enforcing the law uniformly across different geographical areas. Participants were concerned that some type A licence holders sensed that practicing in the community setting and the act of selling medications was beneath their social status as pharmacists. Conclusion A set of factors contribute to the availability of pharmacists in community pharmacies in Pakistan. The change in law should be supplemented with other interventions that contribute to making well‐trained pharmacy personnel available for serving patrons.

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Section: Discussionmentioning

confidence: 97%

Perspectives on an amended law addressing pharmacists' availability in community pharmacies

Qadeer

Amin

2020

Evaluation Clinical Practice

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“…Study sites were community pharmacies located in three divisions (Bahawalpur, Dera Ghazi Khan, and Multan, known as “south Punjab”) of Punjab, Pakistan. The total population in this area is 34,747,064 [ 40 ]. Whereas total 22,319 community pharmacies are located in Punjab province [ 41 ].…”

Section: Methodsmentioning

confidence: 99%

Dispensing of Non-Prescribed Antibiotics from Community Pharmacies of Pakistan: A Cross-Sectional Survey of Pharmacy Staff’s Opinion

et al. 2021

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Community pharmacies are the main channel of antibiotics distribution. We aimed to analyze the dispensing of non-prescribed antibiotics and knowledge of pharmacy staff. We conducted a cross-sectional study in Punjab, Pakistan between December 2017 and March 2018. A self-administered, structured, pretested, and validated bilingual questionnaire was used, and we used chi-square tests in the statistical analysis. A total of 573 (91.7%) pharmacy retailers responded to the survey; 44.0% were aged 31–40 years and all were men. Approximately 81.5% of participants declared that dispensing non-prescribed antibiotics is a common practice in community pharmacies, and 51.1% considered themselves to be authorized to dispense these drugs; 69.3% believed this a contributing factor to antimicrobial resistance. Most (79.1%) respondents believed that this practice promotes irrational antibiotics use, and half (52.2%) considered antimicrobial resistance to be a public health issue. Only 34.5% of respondents reported recommending that patients consult with a doctor prior to using antibiotics, and 61.8% perceived that their dispensing practices reduce patients’ economic burden. Approximately 44.9% of pharmacy retailers stated that they have proper knowledge about antibiotics use. Nitroimidazole was the main class of antibiotic dispensed without a prescription. Dispensing of injectable and broad-spectrum antibiotics can be potential threat for infection cure. Poor knowledge of staff is associated with dispensing of non-prescribed antibiotics. This inappropriate practice must be addressed immediately.

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“…Similar to other countries, community pharmacies in Pakistan are deemed as the most reachable facilities for healthcare services [5]. The private sector makes up the major part of the Pakistani healthcare system and is predominant in pharmacies set up throughout the country [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Knowledge, Attitude and Practice on Antibiotics and Its Resistance: Two Phases Mixed-Methods Online Study Among Pakistani Community Pharmacists to Promote Rational Antibiotics Use

Khan¹,

Khan²,

Hayat³

et al. 2021

Preprint

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Antibiotic resistance (ABR) is an emerging global threat to public health. Substantial evidence has indicated that community pharmacists (CPs) can play a critical role in managing the ever-increasing threat of antibiotic resistance. The study aimed to determine the knowledge, attitude, and practices of CPs (n=180) towards antibiotics and antibiotic resistance as well as to improve the rational use of antibiotics. Two phases of mixed methods (quantitative and qualitative) online study were conducted in Pakistan from August 2019 to March 2020 by using validated questionnaires and semi-structured interview data. Different statistical methods were used to tabulate the quantitative data whereas inductive thematic analysis was conducted to categorize themes from the qualitative data and draw conclusions. Approximately 64.4% were male (mean: 29-33 years old). Overall, CPs had good knowledge of and were familiar with superbugs and their roles in ABR (65.6%, Median=1, IQR=1) although they were poor in differentiating some antibiotic groups with their respective ABR patterns (31.1%, Median=1, IQR=1). Most CPs have a positive attitude towards antibiotics with most (90.0%) having identified ABR as a critical issue in public health (Median=1, IQR=0). Overall, CPs' practices towards antibiotics were reasonable where they tend to educate patients about the rational use of antibiotics (52.8%, Median=1, IQR=1). Two main themes (antibiotics and counseling of patients) were related to self-medication with while educational interventions are the sub-theme. ABR is multifactorial where the subthemes related to budget, time constraints incompetent staff, the absence of CPs, the lack of training, enforcement of laws and regulations are the need of the hour in Pakistan. Effective antibiotic stewardship programs, patient education, and awareness campaigns about antibiotics and ABR along with training of the CPs are important factors that have to be addressed in a timely manner.

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Patients’ Anticipation for the Pharmacies of Rural Communities: A Qualitative Study from Pakistan

Cited by 13 publications

References 39 publications

Perspectives on an amended law addressing pharmacists' availability in community pharmacies

Perspectives on an amended law addressing pharmacists' availability in community pharmacies

Dispensing of Non-Prescribed Antibiotics from Community Pharmacies of Pakistan: A Cross-Sectional Survey of Pharmacy Staff’s Opinion

Knowledge, Attitude and Practice on Antibiotics and Its Resistance: Two Phases Mixed-Methods Online Study Among Pakistani Community Pharmacists to Promote Rational Antibiotics Use

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