Chowdhury Fahmida, Sturm-Ramirez Katharine, Mamun Abdullah Al, Iuliano A Danielle, Bhuiyan Mejbah Uddin, Chisti Mohammod Jobayer, Ahmed Makhdum, Haider Sabbir, Rahman Mahmudur, Azziz-Baumgartner Eduardo
Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Patient Prefer Adherence. 2017 Mar 6;11:479-486. doi: 10.2147/PPA.S121800. eCollection 2017.
Pharmacies in Bangladesh serve as an important source of health service. A survey in Dhaka reported that 48% of respondents with symptoms of acute respiratory illness (ARI) identified local pharmacies as their first point of care. This study explores the factors driving urban customers to seek health care from pharmacies for ARI, their treatment adherence, and outcome.
A cross-sectional study was conducted among 100 selected pharmacies within Dhaka from June to December 2012. Study participants were patients or patients' relatives aged >18 years seeking care for ARI from pharmacies without prescription. Structured interviews were conducted with customers after they sought health service from drug sellers and again over phone 5 days postinterview to discuss treatment adherence and outcome.
We interviewed 302 customers patronizing 76 pharmacies; 186 (62%) sought care for themselves and 116 (38%) sought care for a sick relative. Most customers (215; 71%) were males. The majority (90%) of customers sought care from the study pharmacy as their first point of care, while 18 (6%) had previously sought care from another pharmacy and 11 (4%) from a physician for their illness episodes. The most frequently reported reasons for seeking care from pharmacies were ease of access to pharmacies (86%), lower cost (46%), availability of medicine (33%), knowing the drug seller (20%), and convenient hours of operation (19%). The most commonly recommended drugs were acetaminophen dispensed in 76% (228) of visits, antihistamine in 69% (208), and antibiotics in 42% (126). On follow-up, most (86%) of the customers had recovered and 12% had sought further treatment.
People with ARI preferred to seek care at pharmacies rather than clinics because these pharmacies were more accessible and provided prompt treatment and medicine with no service charge. We recommend raising awareness among drug sellers on proper dispensing practices and enforcement of laws and regulations for drug sales.
孟加拉国的药店是医疗服务的重要来源。达卡的一项调查显示,48%有急性呼吸道疾病(ARI)症状的受访者将当地药店作为他们的首选医疗点。本研究探讨了促使城市消费者因ARI到药店寻求医疗服务的因素、他们的治疗依从性及治疗结果。
2012年6月至12月期间,在达卡选定的100家药店中进行了一项横断面研究。研究参与者为年龄超过18岁、在无处方的情况下从药店寻求ARI治疗的患者或患者亲属。在顾客从售药人员处寻求医疗服务后,以及在访谈后5天通过电话再次进行结构化访谈,以讨论治疗依从性和治疗结果。
我们对光顾76家药店的302名顾客进行了访谈;186人(62%)为自己寻求治疗,116人(38%)为生病的亲属寻求治疗。大多数顾客(215人;71%)为男性。大多数(90%)顾客将研究药店作为他们的首选医疗点,而18人(6%)此前曾因发病到另一家药店寻求治疗,11人(4%)曾去看医生。从药店寻求治疗最常提到 的原因是药店方便前往(86%)、成本较低(46%)、有药品供应(33%)、认识售药人员(20%)以及营业时间便利(19%)。最常被推荐的药物是对乙酰氨基酚,76%(228次就诊)的病例中开具了该药物,69%(208次)开具了抗组胺药,42%(126次)开具了抗生素。随访时,大多数(86%)顾客已康复,12%的顾客寻求了进一步治疗。
ARI患者更倾向于在药店而非诊所寻求治疗,因为这些药店更容易到达,能提供即时治疗且药品免费。我们建议提高售药人员对正确配药做法的认识,并加强药品销售法律法规的执行力度。