THE ANTHROPOLOGY OF PHARMACEUTICALS: A Biographical Approach

Geest, Sjaak van der; Whyte, Susan Reynolds; Hardon, Anita

doi:10.1146/annurev.anthro.25.1.153

Cited by 361 publications

(52 citation statements)

References 124 publications

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“…Some researchers regard such practice as an opportunistic behaviour of doctors and pharmacists, who take advantage of consumers’ ignorance about appropriate treatment [19]. Other claims it could be that “it is easier to satisfy the patients with drugs than with words” [20]. Thus ironically, many malaria patients are reluctant to seek a low-cost malaria treatment at the health centres, instead they seek treatment from the private sector which might not necessary be monitored by the authorities.…”

Section: Resultsmentioning

confidence: 99%

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Social and cultural complexities of anti-malarial drug circulation: an ethnographic investigation in three rural remote communes of Cambodia

Res

2017

Malar J

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BackgroundAnti-malarial medicine has a central role in malaria case management in Cambodia. It is, therefore, essential to study how anti-malarial drugs are distributed and consumed. This study aims to understand the socio-cultural complexity of anti-malarial drugs provision and usage practices.MethodsSemi-structured interviews and observation were conducted in Cambodia at the communal, provincial, and national levels from January 2014 to January 2015. Health ministers, non-governmental officers, anti-malarial medicines distributors, village malaria volunteers and malaria patients were interviewed.FindingsThe findings show that artemisinin-based combination therapy (ACT) flows into unregulated outlets, and was sold without any diagnostic tests. Affordable Medicines Facility for malaria scheme (AMFm) cannot drive ineffective anti-malarial medicines out of the market because ACT is still more expensive due to price absortion by private and public providers. Malaria patients might not consume ACT because of patients’ notions of ‘Korp’, and pharmaceutical and parasitic familiarity. The findings reflect that neither public nor private institutions have the capacity and resources to control the flow of ACT from going into the unlicensed sector. They do not have the ability to ensure that ACT is consumed after a positive rapid diagnostic test.ConclusionsWith a weak regulation system and ailing public health infrastructure, pharmaceutical-neoliberal mechanism like AMFm is not an effective means to eradicate any forms of malaria. Therefore, horizontal programmes, such as public health infrastructure improvement, and population participation must be implemented. Ethnical responsibilities of medical practitioners must be enforced and be included into the national curriculum. The awareness of drug resistance must be implemented at all levels.

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Section: Resultsmentioning

confidence: 99%

“…It is an old traditional concept that is also found in the Philippines. Hardon who conducted a study in the Philippines, in which the informants had explained to him that the medicines prescribed should be compatible to the person using it, which in the local language, is referred to as Hiyang (as cited in [20]).…”

Section: Resultsmentioning

confidence: 99%

Social and cultural complexities of anti-malarial drug circulation: an ethnographic investigation in three rural remote communes of Cambodia

Res

2017

Malar J

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“…There is emerging evidence that antibiotic prescribing is not only a clinical action, but also a social action as well . Various social factors can influence the decision to prescribe antibiotics, including prescriber misperception that while antibiotic overuse is a problem generally, it is not an issue at their home institutions .…”

Section: Discussionmentioning

confidence: 99%

Effect of prescriber peer comparison reports on fluoroquinolone use across a 16‐facility community hospital system

Allen

Dunn²,

Bush³

2019

J Am Coll Clin Pharm

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Introduction Antimicrobial stewardship programs (ASPs) continuously strive to optimize antibiotic use, while minimizing antibiotic‐associated adverse events. Among potential targets for antibiotic use reduction, fluoroquinolones (FQs) are an attractive drug class for ASPs due to their wide spectrum of activity, known adverse event profile, and availability of less toxic therapeutic options. The use of peer comparison on antibiotic use by ASPs has been described but is limited primarily to the outpatient setting. Objectives To assess the impact of peer comparison using prescriber‐specific reports on FQ use and hospital‐acquired Clostridioides difficile rates across a 16‐facility community hospital system. Methods In January 2017, we began providing quarterly facility‐specific peer comparison reports to high‐volume antibiotic prescribers in three different medical specialties across our health‐system: Internal Medicine/Hospitalists/Family Medicine, Intensivists/Pulmonologists, and infectious diseases (ID). We completed a quasi‐experimental study designed to assess aggregated hospital data, evaluating FQ days of therapy/1000 patient days (DOT/1000 PD) in the intervention period (January‐December 2017), and compared with the baseline period (January‐December 2016). Additional outcomes that were evaluated include total antibiotic consumption (DOT/1000 PD), total percentage of antibiotics attributable to FQs, and cases of hospital‐acquired C. difficile/10000 PD (HA‐CD). Results Compared with the baseline period, FQ use decreased by 29% (baseline—83.9 DOT/1000 PD; intervention—58.5 DOT/1000 PD; P < 0.001). The overall percentage of antibiotics that were attributable to FQs also decreased in the intervention period (baseline—15.4%; intervention—11.3%; P < 0.001). During the intervention period, there were no significant increases in other key antibiotic classes, including antipseudomonal beta‐lactams and third‐generation cephalosporins. The rate of HA‐CD decreased by 20% in the intervention period compared with baseline. Conclusion In a large community hospital system, the use of peer comparison reports based on prescriber specialty reduced FQ use, and may potentially reduce adverse events associated with FQ use.

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“…The interview protocols were structured by combining a "funnel-shaped" structure and the "itinerary method" [33-36]. The funnel-shaped structure was adopted to ensure that the interviews allowed for an inductive comprehension of the social reality at stake underlying the PIEM situation.…”

Section: Methodsmentioning

confidence: 99%

Management of pain induced by exercise and mobilization during physical therapy programs: views of patients and care providers

Alami

Desjeux

Lefèvre-Colau

et al. 2011

BMC Musculoskelet Disord

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BackgroundThe expectations of patients for managing pain induced by exercise and mobilization (PIEM) have seldom been investigated. We identified the views of patients and care providers regarding pain management induced by exercise and mobilization during physical therapy programs.MethodsWe performed a qualitative study based on semi-structured interviews with a stratified sample of 12 patients (7 women) and 14 care providers (6 women): 4 general practitioners [GPs], 1 rheumatologist, 1 physical medicine physician, 1 geriatrician, 2 orthopedic surgeons, and 5 physical therapists.ResultsPatients and care providers have differing views on PIEM in the overall management of the state of disease. Patients' descriptions of PIEM were polymorphic, and they experienced it as decreased health-related quality of life. The impact of PIEM was complex, and patient views were sometimes ambivalent, ranging from denial of symptoms to discontinuation of therapy. Care providers agreed that PIEM is generally not integrated in management strategies. Care providers more often emphasized the positive and less often the negative dimensions of PIEM than did patients. However, the consequences of PIEM cited included worsened patient clinical condition, fears about physical therapy, rejection of the physical therapist and refusal of care. PIEM follow-up is not optimal and is characterized by poor transmission of information. Patients expected education on how better to prevent stress and anxiety generated by pain, education on mobilization, and adaptations of physical therapy programs according to pain intensity.ConclusionPIEM management could be optimized by alerting care providers to the situation, improving communication among care providers, and providing education to patients and care providers.

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THE ANTHROPOLOGY OF PHARMACEUTICALS: A Biographical Approach

Cited by 361 publications

References 124 publications

Social and cultural complexities of anti-malarial drug circulation: an ethnographic investigation in three rural remote communes of Cambodia

Social and cultural complexities of anti-malarial drug circulation: an ethnographic investigation in three rural remote communes of Cambodia

Effect of prescriber peer comparison reports on fluoroquinolone use across a 16‐facility community hospital system

Management of pain induced by exercise and mobilization during physical therapy programs: views of patients and care providers

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