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关于无医疗处方配给抗生素的知识、态度、认知和习惯:对西班牙药剂师的定性研究

Knowledge, attitudes, perceptions and habits towards antibiotics dispensed without medical prescription: a qualitative study of Spanish pharmacists.

作者信息

Vazquez-Lago Juan, Gonzalez-Gonzalez Cristian, Zapata-Cachafeiro Maruxa, Lopez-Vazquez Paula, Taracido Margarita, López Ana, Figueiras Adolfo

机构信息

Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.

Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Santiago de Compostela, Spain.

出版信息

BMJ Open. 2017 Oct 8;7(10):e015674. doi: 10.1136/bmjopen-2016-015674.

Abstract

OBJECTIVE

To investigate community pharmacists' knowledge, attitudes, perceptions and habits with regard to antibiotic dispensing without medical prescription in Spain.

METHODS

A qualitative research using focus group method (FG) in Galicia (north-west Spain). FG sessions were conducted in the presence of a moderator. A topic script was developed to lead the discussions, which were audiorecorded to facilitate data interpretation and transcription. Proceedings were transcribed by an independent researcher and interpreted by two researchers working independently. We used the Grounded Theory approach.

SETTING

Community pharmacies in Galicia, region Norwest of Spain.

PARTICIPANTS

Thirty pharmacists agreed to participate in the study, and a total of five FG sessions were conducted with 2-11 pharmacists. We sought to ensure a high degree of heterogeneity in the composition of the groups to improve our study's external validity. Pharmacists' participation had no gender or age restrictions, and an effort was made to form FGs with pharmacists who were both owners and non-owners, provided in all cases that they were Official Colleges of Pharmacists-registered community pharmacists. For the purpose of conducting FG discussions, the basic methodological principle of allowing groups to attain their 'own structural identity' was applied.

MAIN OUTCOME MEASUREMENTS

Community pharmacists' habits and knowledge with regard to antibiotics and identification of the attitudes and/or factors that influence antibiotic dispensing without medical prescription.

RESULTS

Pharmacists attributed the problem of antibiotics dispensed without medical prescription and its relationship to antibiotic resistance to the following attitudes: external responsibility (doctors, dentists and the National Health Service (NHS)); acquiescence; indifference and lack of continuing education.

CONCLUSIONS

Despite being a problem, antibiotic dispensing without a medical prescription is still a common practice in community pharmacies in Galicia, Spain. This practice is attributed to acquiescence, indifference and lack of continuing education. The problem of resistance was ascribed to external responsibility, including that of patients, physicians, dentists and the NHS.

摘要

目的

调查西班牙社区药剂师在无医疗处方情况下配发抗生素方面的知识、态度、认知和习惯。

方法

在西班牙西北部的加利西亚采用焦点小组法进行定性研究。焦点小组会议在主持人在场的情况下进行。制定了一个主题脚本以引导讨论,并进行录音以便于数据解读和转录。记录由一名独立研究人员转录,并由两名独立工作的研究人员进行解读。我们采用了扎根理论方法。

背景

西班牙西北部加利西亚地区的社区药房。

参与者

30名药剂师同意参与研究,共进行了5次焦点小组会议,每次会议有2至11名药剂师参加。我们力求确保小组构成具有高度异质性,以提高研究的外部效度。药剂师的参与没有性别或年龄限制,并努力组建由药房所有者和非所有者组成的焦点小组,前提是他们均为药剂师官方学院注册的社区药剂师。为了进行焦点小组讨论,应用了允许小组形成其“自身结构特征”的基本方法原则。

主要观察指标

社区药剂师在抗生素方面的习惯和知识,以及识别影响无医疗处方配发抗生素的态度和/或因素。

结果

药剂师将无医疗处方配发抗生素的问题及其与抗生素耐药性的关系归因于以下态度:外部责任(医生、牙医和国家医疗服务体系);默许;冷漠和缺乏继续教育。

结论

尽管这是一个问题,但在西班牙加利西亚的社区药房中,无医疗处方配发抗生素仍是一种常见做法。这种做法归因于默许、冷漠和缺乏继续教育。耐药性问题归因于外部责任,包括患者、医生、牙医和国家医疗服务体系的责任。

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