西班牙一项减少无处方抗生素配药的计划的影响
Impact of a program to reduce the dispensing of antibiotics without a prescription in Spain.
作者信息
Gastelurrutia Miguel Angel, Larrañaga Belen, Garay Angel, Echeveste Francisco de Asís, Fernandez-Llimos Fernando
机构信息
Pharmaceutical Care Research Group, University of Granada . Granada ( Spain ).
Drug Information Center, Gipuzkoa Pharmacists Association . San Sebastian ( Spain ).
出版信息
Pharm Pract (Granada). 2013 Oct;11(4):185-90. doi: 10.4321/s1886-36552013000400002. Epub 2013 Dec 20.
BACKGROUND
In 1999, the Pharmacists Association of Gipuzkoa, a Spanish province with a population of 700,000, initiated a campaign to reduce the common practice in community pharmacies of dispensing antibiotics without prescription.
OBJECTIVE
The study was designed to assess the ongoing effectiveness of this program in reducing nonprescription dispensing of antibiotics.
METHODS
In March 2009, 2 young women posed as simulated patients and visited each of the 280 operating community pharmacies in Gipuzkoa. In 139 of these pharmacies, randomly selected, the simulated patients feigned the symptoms of an uncomplicated urinary tract infection and requested an unspecified antibiotic. In the remaining 141, the actress requested a specific antibiotic, only describing her symptoms upon request by the dispensing staff. The rate of nonprescription dispensing had previously been estimated at 70.5% in 2000 and 42.2% in 2004. Univariate and multivariate analyses were performed, based on a number of variables related to the pharmacy and staff.
RESULTS
In the current study, antibiotics were dispensed without prescription by 49 of 280 pharmacies (17.5%). The product- and symptom-based scenarios had similar rates of 16.3% and 18.7%, respectively. The only variables which appeared to affect the nonprescription dispensing rate were the gender of the dispenser, being males more likely to dispense (OR=3.135, 95%CI [1.286, 7.646]), and the number of previous antibiotic-awareness campaigns in which the pharmacy had participated (OR=1.057, 95% CI [1.008, 1.107]). The community population, its number of pharmacies, the years in business of each pharmacy, or its revenue, did not appear to influence the nonprescription dispensing rate.
CONCLUSIONS
A long-term multifactorial program set up by the pharmacists association of Gipuzkoa, Spain, appears to have been effective in reducing the rate at which antibiotics are dispensed without a prescription in community pharmacies.
背景
1999年，拥有70万人口的西班牙吉普斯夸省药剂师协会发起了一项运动，以减少社区药房无处方配药的常见做法。
目的
本研究旨在评估该项目在减少抗生素非处方配药方面的持续有效性。
方法
2009年3月，两名年轻女性假扮模拟患者，走访了吉普斯夸省280家营业中的社区药房。在随机选择的139家药房中，模拟患者假装患有单纯性尿路感染的症状，并要求使用未指明的抗生素。在其余141家药房中，女演员要求使用特定抗生素，仅在配药人员询问时描述其症状。2000年非处方配药率此前估计为70.5%，2004年为42.2%。基于与药房和工作人员相关的一些变量进行了单因素和多因素分析。
结果
在当前研究中，280家药房中有49家（17.5%）无处方配药。基于产品和症状的情景配药率分别为16.3%和18.7%，相似。唯一似乎影响非处方配药率的变量是配药人员的性别，男性更有可能配药（OR = 3.135，95%CI [1.286, 7.646]），以及药房此前参与的抗生素宣传活动次数（OR = 1.057，95%CI [1.008, 1.107]）。社区人口、药房数量、各药房经营年限或其收入似乎均未影响非处方配药率。
结论
西班牙吉普斯夸省药剂师协会设立的长期多因素项目似乎在降低社区药房抗生素无处方配药率方面取得了成效。
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