Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Uganda.
Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Communication Studies, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium.
J Glob Antimicrob Resist. 2021 Jun;25:66-71. doi: 10.1016/j.jgar.2021.02.019. Epub 2021 Mar 2.
This study aimed to explore the experiences and views of healthcare professionals on antibiotic prescription in Eastern Uganda.
This was an exploratory qualitative study using semi-structured interviews. Participants included 16 healthcare professionals from Mbale and Soroti Regional Referral Hospitals. Additionally, two workshops were held (one in each hospital) with a total of 56 healthcare professionals to discuss the findings. Thematic analysis was used to analyse the data.
Healthcare professionals' prescriptions are influenced by (i) healthcare workers' perceptions and practices, (ii) patients' perceptions and beliefs, and (iii) contextual factors. Healthcare workers' prescriptions depend on the presence of bacterial infection and the severity of the condition, the availability and cost of medication, previous experience with antibiotic prescribing, patient characteristics, and trial and error. They also have limited knowledge and share little information on the use of antibiotics with patients. Patient factors included demand for a particular antibiotic, inability to afford expensive drugs, and limited knowledge about antibiotic use and resistance. Contextual factors that contributed to antibiotic prescribing were an overburdened healthcare system, the influence of pharmaceutical companies and pharmacies, the use of (treatment) guidelines, and difficulties with laboratory services.
This study showed that healthcare professionals are aware of the problem of antibiotic resistance but do not feel ownership of the problem. Instead, they rather blame the overburdened system, local drug shops, pharmacies, drug representatives and patients. There is a need for a multisectoral and holistic approach toward fighting antibiotic resistance.
本研究旨在探讨乌干达东部医疗保健专业人员对抗生素处方的经验和看法。
这是一项使用半结构式访谈的探索性定性研究。参与者包括来自姆巴莱和索罗蒂地区转诊医院的 16 名医疗保健专业人员。此外，在两个医院（每家医院一个）举行了两次研讨会，共有 56 名医疗保健专业人员讨论研究结果。使用主题分析来分析数据。
医疗保健专业人员的处方受到以下因素的影响：（i）医护人员的认知和实践，（ii）患者的认知和信念，以及（iii）背景因素。医护人员的处方取决于是否存在细菌感染以及病情的严重程度、药物的可用性和成本、以前使用抗生素的经验、患者的特点、以及试错。他们对抗生素的使用也知之甚少，与患者分享的信息很少。患者因素包括对特定抗生素的需求、无法负担昂贵的药物、以及对抗生素使用和耐药性的了解有限。促成抗生素处方的背景因素包括医疗体系负担过重、制药公司和药店的影响、（治疗）指南的使用以及实验室服务的困难。
本研究表明，医疗保健专业人员意识到抗生素耐药性问题，但不认为自己对此问题负有责任。相反，他们更倾向于将责任归咎于负担过重的体系、当地的药店、药房、药品代表和患者。需要采取多部门和整体的方法来对抗抗生素耐药性。
