IRRATIONAL USE OF ANTIBIOTICS AND ROLE OF PHARMACISTS- AN INSIGHT FROM A QUALITATIVE STUDY IN NEW DELHI, INDIA
Author(s)
Kotwani A1, Wattal C2, Joshi PC3, Holloway K41V. P. Chest Institute, University of Delhi, Delhi, India, 2Sir Ganga Ram Hospital, New Delhi, India, 3Delhi University, Delhi, India, 4World Health Organization, New Delhi, India
OBJECTIVES: Antimicrobial resistance (AMR) is a global public health problem. Antibiotic misuse is one of the important factors for increasing trend of AMR. In developing countries like India, pharmacists often dispense “prescription only” drugs, like antibiotics to patients who do not have a prescription. It is important to understand the dispensing practices and behaviour of community pharmacists in order to develop policy interventions that will effectively improve the use of antibiotics at the community level. METHODS: Focus group discussions (FGDs) were held for five municipal wards of Delhi with retail pharmacists, public sector pharmacists and the office-bearers of pharmacists’ associations. Data on antibiotic use and resistance was collected earlier in these five wards. FGDs (n=3 with 40 pharmacists) were analysed through grounded theory. RESULTS: From the FGDs four broad themes identified were: prescribing and dispensing behaviour; commercial interests; advisory role; and intervention strategies for rational use of antibiotics which were further divided into sub themes. FGDs with pharmacists working in the public sector found that, besides the factors listed above, overstock and near-expiry, and under supply of antibiotics, promoted antibiotic over-use or under-use. Findings elucidates pharmacists’ role in increasing AMR through inappropriate dispensing practices and profit-driven irrational prescribing. Suggestions for interventions from pharmacists were (1) education to increase awareness about rational use and resistance to antibiotics for pharmacists; (2) involving them as partners to create awareness among communities for rational use and resistance to antibiotics; and (3) developing an easy return policy for near-expiry antibiotics in public sector facilities. CONCLUSIONS: In a scenario where pharmacists are not only intermediates between prescribers and users, but are also prescribing and dispensing, they become important stakeholders for intervention programs. A multidisciplinary team of policymakers should design sustainable intervention programs to improve pharmacists’ antibiotic prescribing behavior, as well as awareness programs for community members.
Conference/Value in Health Info
2011-05, ISPOR 2011, Baltimore, MD, USA
Value in Health, Vol. 14, No. 3 (May 2011)
Code
PHP86
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
Multiple Diseases