Perceptions of community pharmacists regarding their role in antimicrobial stewardship in Pakistan: A way forward

Hashmi, Ayisha; Haq, Muhammad Ijaz Ul; Malik, Madeeha; Hussain, Azhar; Gajdács, Márió; Jamshed, Shazia Qasim

doi:10.1016/j.heliyon.2023.e14843

Cited by 8 publications

(4 citation statements)

References 35 publications

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“…It was also revealed that CPs with job status as ’Manager’ and 3–5 years of experience were more likely to be associated with poor DAwP practices than ’Staff pharmacists’ and those with>5 years of experience. These findings are comparable with the studies in which CP’s work status and job experience were significantly associated with the DAwP practices [ 51 – 53 ]. This might be because, in many developing countries like Pakistan, there is no establishment of continuing medical education (CME) programs by which CPs can keep their knowledge up to date [ 54 ].…”

Section: Discussionsupporting

confidence: 88%

Assessment of knowledge, attitudes, and practices among community pharmacists in Lahore regarding antibiotic dispensing without prescription: A cross-sectional study

Nabeel,

Ali,

Sarwar

et al. 2024

PLoS ONE

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Objectives The irrational dispensing practices are responsible for antibiotic abuse and the spread of antibiotic resistance. Thus, the present study aims to evaluate the knowledge, attitudes, and practices of community pharmacists (CPs) regarding dispensing antibiotics without prescription (DAwP). Method A descriptive, cross-sectional study was conducted between March 1, 2023, and March 31, 2023, in community pharmacy settings of Lahore, Pakistan. A self-administered and pretested questionnaire was used for the data collection. Logistic regression analysis was used to determine the factors associated with the practices of community pharmacists. Data were analyzed using SPSS (version 26) and MS Office (2016). Results Among 359 respondents, many strongly agreed/agreed with the statements "DAwP is contributing to the development of antimicrobial resistance" (83%, n = 298) and "Antibiotic resistance has become a public health issue" (81.9%, n = 249). Overall, most of the community pharmacists claimed that the unwillingness of patients to visit physicians for non-serious infections (75.2%, n = 270) and good knowledge of pharmacists about the use of antibiotics (51%, n = 183) were the most common reasons attributable to dispensing of antibiotics without prescription. Cephalosporin (n = 260, 72.4%), penicillin (n = 254, 70.8%), and tetracyclines (n = 170, 47.4%) were the most commonly dispensed classes of antibiotics without prescription due to cold, flu and diarrhea. Most community pharmacists never/sometimes warn patients about the potential side effects of medicines (79.1%, n = 284). Logistic regression analysis revealed that community pharmacists 31–40 years of age (OR = 0.568, 95%CI = 0.348–0.927, p-value = 0.024) were significantly less associated with poor practices of dispensing antibiotics without prescription (DAwP) while those who were ’Managers’ (OR = 4.222, 95%CI = 2.542–7.011, p-value = <0.001), had 3–5 years of experience (OR = 2.241, 95%CI = 1.183–4.243, p-value = 0.013), dispensed ≤25 antibiotics per day (OR = 12.375, 95%CI = 5.177–29.583, p-value = <0.001), were more likely to be associated with poor practices of dispensing of antibiotics without prescription. Conclusion The community pharmacists had adequate knowledge, positive attitudes, and poor practices towards DAwP. Demographical factors such as age, job status, and work experience were the determinants of community pharmacists’ practices towards dispensing antibiotics without prescription (DAwP). Hence, a multifaceted approach, including educational interventions, is needed to reduce the dispensing of antibiotics without prescription (DAwP).

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Section: Discussionsupporting

confidence: 88%

Assessment of knowledge, attitudes, and practices among community pharmacists in Lahore regarding antibiotic dispensing without prescription: A cross-sectional study

Nabeel,

Ali,

Sarwar

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…It was also revealed that CPs with job status as 'Manager' and 3-5 years of experience were more likely to be associated with poor DAwP practices than 'Staff pharmacists' and those with>5 years of experience. These findings are comparable with the studies in which CP's work status and job experience were significantly associated with the DAwP practices [51][52][53]. This might be because, in many developing countries like Pakistan, there is no establishment of continuing medical education (CME) programs by which CPs can keep their knowledge up to date [54].…”

Section: Plos Onesupporting

confidence: 75%

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“…The implementation of AMS is associated with reduced antibiotic use, fewer new prescriptions and higher physician satisfaction. Moreover, a US study showed a significant reduction in the number of unnecessary antimicrobial prescriptions after adopting AMS programs in their emergency department ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

Dispensing of antibiotics for tuberculosis patients using standardized patient approach at community pharmacies: results from a cross-sectional study in Pakistan

Gillani,

Arshad,

Mujtaba

et al. 2024

Front. Public Health

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BackgroundPakistan is among top countries for antibiotic consumption around the globe and patients often receive antibiotics directly from community pharmacies. Thus, our aim was to assess the drug dispensing practices of pharmacies for presumed and confirmed tuberculosis by using standardized patients’ method in Pakistan.MethodsIn this cross-sectional study, we adopted two standardized patient cases in pharmacies of three cities of Punjab. The first case involved a presumed tuberculosis patient presenting with 2–3 weeks of cough and fever (Case-1), and the second case involved a confirmed tuberculosis patient carrying microbiologically confirmed tuberculosis results (Case-2). The ideal management for Cases-1 and Case-2 is referral of standardized patients to a healthcare provider without dispensing antibiotics or steroids, or both. The differences in antibiotic use, steroid use, and the number of medicines dispensed in referred and non-referred patients between Case-1 and Case-2 were analyzed using descriptive statistics.ResultsBetween April 1, 2020, and July 31, 2020, standardized patients completed 575 out of 598 interactions among community pharmacies in Lahore, Rawalpindi, and Sialkot. We recorded ideal management in 115 (37.7%) of the 305 Case-1 interactions and 130 (48.1%) of the 270 Case-2 interactions. Antibiotic dispensing was higher in Case-1, with 71 out of 305 instances (23.3%), than in Case-2 interactions, with 27 out of 270 instances (10.0%). Anti-tuberculosis drugs were dispensed to 1 patient in Case-1 (0.3%) and to 19 patients (7.0%) in Case-2.ConclusionSlightly more than one-third of pharmacies in Punjab, Pakistan, ideally managed patients with presumed tuberculosis, but almost half of them ideally managed cases of confirmed tuberculosis. The presence of confirmed diagnosis slightly changes the behavior in the correct management of patients.

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Perceptions of community pharmacists regarding their role in antimicrobial stewardship in Pakistan: A way forward

Cited by 8 publications

References 35 publications

Assessment of knowledge, attitudes, and practices among community pharmacists in Lahore regarding antibiotic dispensing without prescription: A cross-sectional study

Assessment of knowledge, attitudes, and practices among community pharmacists in Lahore regarding antibiotic dispensing without prescription: A cross-sectional study

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Dispensing of antibiotics for tuberculosis patients using standardized patient approach at community pharmacies: results from a cross-sectional study in Pakistan

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