Institute for Population and Social Research, Mahidol University, Phutthamonthon, Thailand.
Department of Clinical Microbiology, Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, Netherlands.
PLoS One. 2024 Apr 2;19(4):e0298972. doi: 10.1371/journal.pone.0298972. eCollection 2024.
It is known that the misuse and overuse of antimicrobials leads to antimicrobial resistance (AMR). Effective communication between dispensers and users is thus crucial in reducing inappropriate antibiotic use.
This study aims to gain a better understanding of communication around the use of antibiotics in the community and seeks potential implementation strategies to change dispenser and user practices in communication aspects.
Qualitative methods were employed, including in-depth interviews with 18 drug suppliers and 16 community members, and eight focus group discussions with key informants. Data were collected in the Kanchanaburi Demographic Health Surveillance System in urban and semi-urban communities in the western region of Thailand. The thematic analysis included communication quality, communication and imbalanced power, and misconceptions and instruction. The OpenCode qualitative software program was employed.
The study revealed that the quality of communication was significantly influenced by the interaction of antibiotic dispensing with language and information. This interaction creates communication constraints between those dispensing antibiotics and the recipients, resulting in a less-than-optimal exchange of information. Consequently, users received limited information concerning the proper use of antibiotics. Furthermore, power imbalances and communication dynamics were perpetuated, mainly stemming from varying levels of access to and knowledge about antibiotics. This imbalance in power dynamics became evident between those dispensing antibiotics and the users. Users, as well as dispensers lacking proper qualifications, found themselves in a precarious position due to their inadequate knowledge of antibiotics. Moreover, it is noteworthy that misconceptions often conflicted with antibiotic instructions, leading to challenges in adhering to antibiotic regimens. These challenges primarily arose from misconceptions about antibiotics and concerns about potential side effects, particularly when users started to feel better.
The findings highlight the importance of enhancing communication between dispensers and users through future interventions. These interventions should aim to bolster user understanding of antibiotics and provide clear, trustworthy instructions for their proper usage. Investigating innovative communication methods, such as the use of QR codes, presents a promising avenue for consideration. By addressing these communication gaps, we can advocate for the appropriate utilization of antibiotics and mitigate the prevalence of AMR.
众所周知，抗生素的滥用和过度使用会导致抗生素耐药性（AMR）。因此，药剂师和用户之间的有效沟通对于减少不合理使用抗生素至关重要。
本研究旨在更深入地了解社区中抗生素使用方面的沟通情况，并寻求潜在的实施策略，以改变药剂师和用户在沟通方面的实践。
采用定性方法，包括对 18 名药剂师和 16 名社区成员进行深入访谈，以及对 8 组关键信息提供者进行焦点小组讨论。数据收集于泰国西部坎查纳布里人口动态监测系统的城市和半城市社区。主题分析包括沟通质量、沟通和不平衡权力以及误解和指导。采用 OpenCode 定性软件程序进行分析。
研究表明，抗生素配药与语言和信息的相互作用显著影响沟通质量。这种相互作用在配药者和接受者之间造成了沟通障碍，导致信息交流不理想。因此，用户获得的关于抗生素正确使用的信息有限。此外，权力失衡和沟通动态得以延续，主要源于对抗生素的获取和了解程度的不同。这种权力动态的不平衡在配药者和使用者之间表现明显。由于对抗生素的了解不足，使用者和缺乏适当资质的配药者都处于弱势地位。此外，值得注意的是，误解往往与抗生素使用说明相冲突，导致难以遵循抗生素治疗方案。这些挑战主要源于对抗生素的误解以及对潜在副作用的担忧，尤其是当用户开始感觉好转时。
研究结果强调了通过未来干预措施加强药剂师和用户之间沟通的重要性。这些干预措施应旨在增强用户对抗生素的理解，并为其正确使用提供清晰、可信的说明。研究创新沟通方法，如使用 QR 码，是一个值得考虑的有前途的途径。通过解决这些沟通差距，我们可以倡导合理使用抗生素，减少抗生素耐药性的发生。
