Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan
Background There are concerns with the extent of dispensing of antibiotics among community pharmacists in Pakistan often without a prescription adding to antimicrobial resistance (AMR) rates.Objective To explore the determinants of AMR and the pattern of antimicrobial dispensing among community phar...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2019-07-01
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| Series: | Family Medicine and Community Health |
| Online Access: | https://fmch.bmj.com/content/7/3/e000138.full |
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| author | Mohamed Azmi Hassali Zikria Saleem Furqan Khurshid Hashmi Brian Godman Fahad Saleem |
| author_facet | Mohamed Azmi Hassali Zikria Saleem Furqan Khurshid Hashmi Brian Godman Fahad Saleem |
| author_sort | Mohamed Azmi Hassali |
| collection | DOAJ |
| description | Background There are concerns with the extent of dispensing of antibiotics among community pharmacists in Pakistan often without a prescription adding to antimicrobial resistance (AMR) rates.Objective To explore the determinants of AMR and the pattern of antimicrobial dispensing among community pharmacists.Design In this qualitative study design, a semistructured interview guide was developed based on an in-depth review of published papers. Audio-recorded interviews with transcripts were analysed by thematic content analysis.Setting Interviews were conducted among community pharmacists in Lahore, Pakistan.Participants In order to obtain individual points of view, in-depth face-to-face interviews with purposively selected pharmacists were conducted.Results A total of 12 pharmacists were interviewed for the study. After analysis, four major themes emerged: (1) knowledge and perception of community pharmacists about antimicrobials, (2) antimicrobial dispensing practices of community pharmacists, (3) determinants of AMR, (4) potential interventions to control AMR. Most of the pharmacists have limited knowledge about AMR, antimicrobial stewardship programmes and related guidelines. However, all the pharmacists strongly agreed that different appropriate actions should be taken in order to rationalise future antimicrobial use.Conclusion The results indicated that irrational antimicrobial dispensing and use is common among community pharmacists in Pakistan owing to lack of knowledge. The community pharmacists perceived that behaviour of patients and the societal environment contributed to irrational antimicrobial use and subsequent development of AMR. They suggested a need for a multidisciplinary framework in order to improve future antimicrobial use and reduce AMR in Pakistan. |
| format | Article |
| id | doaj-art-82e202b264f04321a955adeb6435c127 |
| institution | OA Journals |
| issn | 2305-6983 2009-8774 |
| language | English |
| publishDate | 2019-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Family Medicine and Community Health |
| spelling | doaj-art-82e202b264f04321a955adeb6435c1272025-08-20T02:12:10ZengBMJ Publishing GroupFamily Medicine and Community Health2305-69832009-87742019-07-017310.1136/fmch-2019-000138Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in PakistanMohamed Azmi Hassali0Zikria Saleem1Furqan Khurshid Hashmi2Brian Godman3Fahad Saleem4School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, MalaysiaSchool of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, MalaysiaUniversity College of Pharmacy, University of the Punjab, Lahore, PakistanStrathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UKFaculty of Pharmacy and Health sciences, University of Balochistan, Quetta, PakistanBackground There are concerns with the extent of dispensing of antibiotics among community pharmacists in Pakistan often without a prescription adding to antimicrobial resistance (AMR) rates.Objective To explore the determinants of AMR and the pattern of antimicrobial dispensing among community pharmacists.Design In this qualitative study design, a semistructured interview guide was developed based on an in-depth review of published papers. Audio-recorded interviews with transcripts were analysed by thematic content analysis.Setting Interviews were conducted among community pharmacists in Lahore, Pakistan.Participants In order to obtain individual points of view, in-depth face-to-face interviews with purposively selected pharmacists were conducted.Results A total of 12 pharmacists were interviewed for the study. After analysis, four major themes emerged: (1) knowledge and perception of community pharmacists about antimicrobials, (2) antimicrobial dispensing practices of community pharmacists, (3) determinants of AMR, (4) potential interventions to control AMR. Most of the pharmacists have limited knowledge about AMR, antimicrobial stewardship programmes and related guidelines. However, all the pharmacists strongly agreed that different appropriate actions should be taken in order to rationalise future antimicrobial use.Conclusion The results indicated that irrational antimicrobial dispensing and use is common among community pharmacists in Pakistan owing to lack of knowledge. The community pharmacists perceived that behaviour of patients and the societal environment contributed to irrational antimicrobial use and subsequent development of AMR. They suggested a need for a multidisciplinary framework in order to improve future antimicrobial use and reduce AMR in Pakistan.https://fmch.bmj.com/content/7/3/e000138.full |
| spellingShingle | Mohamed Azmi Hassali Zikria Saleem Furqan Khurshid Hashmi Brian Godman Fahad Saleem Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan Family Medicine and Community Health |
| title | Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan |
| title_full | Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan |
| title_fullStr | Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan |
| title_full_unstemmed | Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan |
| title_short | Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan |
| title_sort | antimicrobial dispensing practices and determinants of antimicrobial resistance a qualitative study among community pharmacists in pakistan |
| url | https://fmch.bmj.com/content/7/3/e000138.full |
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