Zayegh Iman, Charrois Theresa L, Hughes Jeffery, Hoti Kreshnik
School of Pharmacy, Curtin University, Kent St, Bentley, WA 6102 Australia.
Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 116 St and 85 Ave., Edmonton, AB T6G 2R3 Canada.
J Pharm Policy Pract. 2014 Dec 16;7(1):17. doi: 10.1186/s40545-014-0017-z. eCollection 2014.
This study aimed to explore patients' utilization of repeat prescriptions for antibiotics indicated in upper respiratory tract infections (URTI). An emphasis was placed on whether the current system of repeat prescriptions contributes to patients self-diagnosing infections and if so, identify the common reasons for this.
This is a prospective study of self-reported use of repeat antibiotic prescriptions by pharmacy consumers presenting with repeat prescriptions for antibiotics commonly indicated in URTIs. Data were collected via self-completed surveys in Perth metropolitan pharmacies.
A total of 123 respondents participated in this study from 19 Perth metropolitan pharmacies. Of the respondents, approximately a third of them (33.9%) presented to the pharmacy to fill their antibiotic repeat prescription one month or more from the time the original prescription was written (i.e. time when original diagnosis was made by a doctor). Over two thirds of respondents indicated to not have consulted their doctor prior to presenting to the pharmacy to have their antibiotic repeat prescription dispensed (i.e. 68.3%). The most common reasons for this were that their 'doctor had told them to take the second course' (38%), followed by potential self-diagnosis (29%), i.e. 'they had the same symptoms as the last time they took the antibiotics'. Approximately one third (33.1%) of respondents indicated they 'were not told what the repeat prescription was needed for' when they were originally prescribed the antibiotic. Respondents who presented to fill their repeat prescription more than 2 weeks after the original prescription written were more likely not have consulted their doctor (p = 0.006, 95% CI [1.16, 2.01]) and not to know why their repeat was needed (p = 0.010, 95% CI [1.07, 2.18]).
Findings of this study suggested that the current 12 month validity of antibiotics repeat prescriptions is potentially contributing to patients' self-diagnosis of URTIs and therefore potential misuse of antibiotics. This may be contributing to the rise of antimicrobial resistance. The study also outlines some common reasons for patients potentially self-diagnosing URTIs when using repeat prescriptions. Larger Australian studies are needed to confirm these findings.
本研究旨在探讨患者对上呼吸道感染（URTI）中抗生素重复处方的使用情况。重点关注当前的重复处方系统是否促使患者自行诊断感染，如果是，找出其中的常见原因。
这是一项前瞻性研究，针对前来珀斯市区药房开具URTI常用抗生素重复处方的药房消费者自我报告的重复抗生素处方使用情况。数据通过在珀斯市区药房进行的自我填写调查问卷收集。
共有123名受访者参与了本研究，他们来自珀斯市区的19家药房。在受访者中，约三分之一（33.9%）在原处方开具一个月或更长时间后（即医生做出原诊断的时间）才到药房领取抗生素重复处方。超过三分之二的受访者表示在到药房领取抗生素重复处方之前未咨询过医生（即68.3%）。最常见的原因是“医生告诉他们服用第二个疗程”（38%），其次是可能的自我诊断（29%），即“他们有与上次服用抗生素时相同的症状”。约三分之一（33.1%）的受访者表示在最初开具抗生素处方时“未被告知为何需要重复处方”。在原处方开具两周后前来领取重复处方的受访者更有可能未咨询医生（p = 0.006，95%置信区间[1.16, 2.01]），且不知道为何需要重复处方（p = 0.010，95%置信区间[1.07, 2.18]）。
本研究结果表明，目前抗生素重复处方12个月的有效期可能促使患者自行诊断URTI，从而可能导致抗生素的滥用。这可能是导致抗菌药物耐药性上升的原因之一。该研究还概述了患者在使用重复处方时可能自行诊断URTI的一些常见原因。需要更大规模的澳大利亚研究来证实这些发现。
