Over-the-counter antibiotic dispensing by pharmacies: a standardised patient study in Udupi district, India
Background Antimicrobial resistance is a global health emergency, and one of the contributing factors is overuse and misuse of antibiotics. India is one of the world’s largest consumers of antibiotics, and inappropriate use is potentially widespread. This study aimed to use standardised patients (SP...
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BMJ Publishing Group
2019-12-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/4/6/e001869.full |
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| author | Amrita Daftary Madhukar Pai Vaidehi Nafade Sophie Huddart Giorgia Sulis Sonal Sekhar Miraj Kavitha Saravu |
| author_facet | Amrita Daftary Madhukar Pai Vaidehi Nafade Sophie Huddart Giorgia Sulis Sonal Sekhar Miraj Kavitha Saravu |
| author_sort | Amrita Daftary |
| collection | DOAJ |
| description | Background Antimicrobial resistance is a global health emergency, and one of the contributing factors is overuse and misuse of antibiotics. India is one of the world’s largest consumers of antibiotics, and inappropriate use is potentially widespread. This study aimed to use standardised patients (SPs) to measure over-the-counter antibiotic dispensing in one region.Methods Three adults from the local community in Udupi, India, were recruited and trained as SPs. Three conditions, in both adults and children, were considered: diarrhoea, upper respiratory tract infection and acute fever. Adult SPs were used as proxies for the paediatric cases.Results A total of 1522 SP interactions were successfully completed from 279 pharmacies. The proportion of SP interactions resulting in the provision of an antibiotic was 4.34% (95% CI 3.04% to 6.08%) for adult SPs and 2.89% (95% CI 1.8% to 4.4%) for child SPs. In the model, referral to another provider was associated with an OR 0.38 (95% CI 0.18 to 0.79), the number of questions asked was associated with an OR 1.54 (95% CI 1.30 to 1.84) and an SP–pharmacist interaction lasting longer than 3 min was associated with an OR 3.03 (95% CI 1.11 to 8.27) as compared with an interaction lasting less than 1 min.Conclusion Over-the-counter antibiotic dispensing rate was low in Udupi district and substantially lower than previously published SP studies in other regions of India. Dispensing was lowest when pharmacies referred to a doctor, and higher when pharmacies asked more questions or spent more time with clients. |
| format | Article |
| id | doaj-art-5627ea3de77045bda12d9abc6c76adc8 |
| institution | OA Journals |
| issn | 2059-7908 |
| language | English |
| publishDate | 2019-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-5627ea3de77045bda12d9abc6c76adc82025-08-20T02:08:46ZengBMJ Publishing GroupBMJ Global Health2059-79082019-12-014610.1136/bmjgh-2019-001869Over-the-counter antibiotic dispensing by pharmacies: a standardised patient study in Udupi district, IndiaAmrita Daftary0Madhukar Pai1Vaidehi Nafade2Sophie Huddart3Giorgia Sulis4Sonal Sekhar Miraj5Kavitha Saravu6Centre for the AIDS Programme of Research, Durban, KwaZulu-Natal, South AfricaMcGill International TB Centre, McGill University, Montreal, Québec, CanadaEpidemiology and Biostatistics, McGill University, Montreal, Québec, CanadaEpidemiology & Biostatistics, McGill University, Montreal, Quebec, CanadaDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, CanadaDepartment of Pharmacy Parctice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, IndiaDepartment of Infectious Diseases, Kasturba Medical College Manipal, Manipal, Karnataka, IndiaBackground Antimicrobial resistance is a global health emergency, and one of the contributing factors is overuse and misuse of antibiotics. India is one of the world’s largest consumers of antibiotics, and inappropriate use is potentially widespread. This study aimed to use standardised patients (SPs) to measure over-the-counter antibiotic dispensing in one region.Methods Three adults from the local community in Udupi, India, were recruited and trained as SPs. Three conditions, in both adults and children, were considered: diarrhoea, upper respiratory tract infection and acute fever. Adult SPs were used as proxies for the paediatric cases.Results A total of 1522 SP interactions were successfully completed from 279 pharmacies. The proportion of SP interactions resulting in the provision of an antibiotic was 4.34% (95% CI 3.04% to 6.08%) for adult SPs and 2.89% (95% CI 1.8% to 4.4%) for child SPs. In the model, referral to another provider was associated with an OR 0.38 (95% CI 0.18 to 0.79), the number of questions asked was associated with an OR 1.54 (95% CI 1.30 to 1.84) and an SP–pharmacist interaction lasting longer than 3 min was associated with an OR 3.03 (95% CI 1.11 to 8.27) as compared with an interaction lasting less than 1 min.Conclusion Over-the-counter antibiotic dispensing rate was low in Udupi district and substantially lower than previously published SP studies in other regions of India. Dispensing was lowest when pharmacies referred to a doctor, and higher when pharmacies asked more questions or spent more time with clients.https://gh.bmj.com/content/4/6/e001869.full |
| spellingShingle | Amrita Daftary Madhukar Pai Vaidehi Nafade Sophie Huddart Giorgia Sulis Sonal Sekhar Miraj Kavitha Saravu Over-the-counter antibiotic dispensing by pharmacies: a standardised patient study in Udupi district, India BMJ Global Health |
| title | Over-the-counter antibiotic dispensing by pharmacies: a standardised patient study in Udupi district, India |
| title_full | Over-the-counter antibiotic dispensing by pharmacies: a standardised patient study in Udupi district, India |
| title_fullStr | Over-the-counter antibiotic dispensing by pharmacies: a standardised patient study in Udupi district, India |
| title_full_unstemmed | Over-the-counter antibiotic dispensing by pharmacies: a standardised patient study in Udupi district, India |
| title_short | Over-the-counter antibiotic dispensing by pharmacies: a standardised patient study in Udupi district, India |
| title_sort | over the counter antibiotic dispensing by pharmacies a standardised patient study in udupi district india |
| url | https://gh.bmj.com/content/4/6/e001869.full |
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