scholarly journals Community Pharmacies, Drug Stores, and Antibiotic Dispensing in Indonesia: A Qualitative Study

2021 ◽  
Author(s):  
Astri Ferdiana ◽  
Marco Liverani ◽  
Mishal Khan ◽  
Luh Putu Lila Wulandari ◽  
Yusuf Ari Mashuri ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Financial Incentives ◽  
Access To Medicines ◽  
Careful Examination ◽  
Community Pharmacies ◽  
Unintended Effects ◽  
Policy Reforms ◽  
Self Medication ◽  
Middle Income ◽  
Dispensing Practices

Abstract Background Inappropriate dispensing of antibiotics at community pharmacies is an important driver of antimicrobial resistance (AMR), particularly in low- and middle-income countries. Thus, a better understanding of dispensing practices is crucial to inform national, regional, and global responses to AMR. This requires careful examination of the interactions between vendors and clients, sensitive to the context in which these interactions take place. Methods In 2019, we conducted a qualitative study to examine antibiotic dispensing practices and associated drivers in Indonesia, where self-medication with antibiotics purchased at community pharmacies and drug stores is widespread. Data collection involved 60 in-depth interviews with staff at pharmacies and drug stores (n = 31) and their clients (n = 29), conducted in an urban (Bekasi) and a semi-rural location (Tabalong) to capture different markets and different contexts of access to medicines. Interview transcripts were analysed using thematic content analysis. Results A common dispensing pattern was the direct request of antibiotics by clients, who walked into pharmacies or drug stores and asked for antibiotics without prescription, either by their generic/brand name or by showing an empty package or sample. A less common pattern was recommendation to use antibiotics by the vendor after the patient presented with symptoms. Drivers of inappropriate antibiotic dispensing included poor knowledge of antibiotics and AMR driving patient demand, financial incentives to maximise medicine sales in an increasingly competitive market, the unintended effects of health policy reforms, and weak regulatory enforcement. Conclusions Inappropriate dispensing of antibiotics in community pharmacies is the outcome of complex interactions between vendors and clients, shaped by wider and changing socio-economic processes. Concerted action should be taken to address this complexity and involve such providers in the development and implementation of AMR national action plans.

scholarly journals Community pharmacies, drug stores, and antibiotic dispensing in Indonesia: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Astri Ferdiana ◽  
Marco Liverani ◽  
Mishal Khan ◽  
Luh Putu Lila Wulandari ◽  
Yusuf Ari Mashuri ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Financial Incentives ◽  
Market Competition ◽  
Essential Medicines ◽  
Careful Examination ◽  
Policy Outcomes ◽  
Community Pharmacies ◽  
Unintended Effects ◽  
Self Medication ◽  
Dispensing Practices

Abstract Background Inappropriate dispensing of antibiotics at community pharmacies is an important driver of antimicrobial resistance (AMR), particularly in low- and middle-income countries. Thus, a better understanding of dispensing practices is crucial to inform national, regional, and global responses to AMR. This requires careful examination of the interactions between vendors and clients, sensitive to the context in which these interactions take place. Methods In 2019, we conducted a qualitative study to examine antibiotic dispensing practices and associated drivers in Indonesia, where self-medication with antibiotics purchased at community pharmacies and drug stores is widespread. Data collection involved 59 in-depth interviews with staff at pharmacies and drug stores (n = 31) and their clients (n = 28), conducted in an urban (Bekasi) and a semi-rural location (Tabalong) to capture different markets and different contexts of access to medicines. Interview transcripts were analysed using thematic content analysis. Results A common dispensing pattern was the direct request of antibiotics by clients, who walked into pharmacies or drug stores and asked for antibiotics without prescription, either by their generic/brand name or by showing an empty package or sample. A less common pattern was recommendation to use antibiotics by the vendor after the patient presented with symptoms. Drivers of inappropriate antibiotic dispensing included poor knowledge of antibiotics and AMR, financial incentives to maximise medicine sales in an increasingly competitive market, the unintended effects of health policy reforms to make antibiotics and other essential medicines freely available to all, and weak regulatory enforcement. Conclusions Inappropriate dispensing of antibiotics in community pharmacies and drug stores is the outcome of complex interactions between vendors and clients, shaped by wider and changing socio-economic processes. In Indonesia, as in many other LMICs with large and informal private sectors, concerted action should be taken to engage such providers in plans to reduce AMR. This would help avert unintended effects of market competition and adverse policy outcomes, as observed in this study.

scholarly journals Prevalence of drug-related problems in self-medication in Danish community pharmacies

2012 ◽  
Vol 3 (4) ◽  
Author(s):  
Bente Frøkjær ◽  
Tina Bolvig ◽  
Nina Griese ◽  
Hanne Herborg ◽  
Charlotte Rossing
Keyword(s):  
Original Research ◽  
Community Pharmacies ◽  
Unintended Effects ◽  
Drug Related Problems ◽  
Pharmacy Staff ◽  
Self Medication ◽  
Over The Counter ◽  
Professional Advice ◽  
Presenting Symptoms ◽  
Otc Medicines

Background: Drug-related problems are known to be a major problem associated with pharmacotherapy. A broad range of studies, mainly in the area of prescription-only medicines, supports this fact. Only a few studies have evaluated drug-related problems with over-the-counter medicine and the role of community pharmacies in this. Purpose: To quantify drug-related problems in self-medication (use of over-the-counter medicine) identified by community pharmacies in Denmark and to document the interventions by pharmacy staff in relation to the identified drug-related problems. Method: A descriptive study mapping drug-related problems in self-medication registered at the counter at a selected number of Danish community pharmacies. Results: Data for 3,868 consecutive customers with requests for over-the-counter (OTC) medicines were registered at 39 community pharmacies. The pharmacies registered a total number of 4,324 OTC medicines requests, illustrating that a customer requested 1.1 OTC medicines on average. Drug-related problems (DRPs) were identified for 813 customers, equivalent to DRPs for 21.0 % of all customers, presenting symptoms or requesting OTC medicines, and for 20 % of all over-the-counter medicines requests. 1,239 DRPs were registered, corresponding to an average of 1.5 DRPs per customer requesting OTC medicines. Community pharmacies estimated that they solved or partly solved 76.2 % of the detected DRPs; 73 % were solved without involving a general practitioner. Conclusions: DRPs were identified for 21.0 % of the pharmacy customers presenting a symptom or asking for an OTC medicine. The community pharmacy counselled the customers with DRPs more thoroughly than other customers by giving 2.4 pieces of professional advice, compared to an average of 2.1 to customers in general. It is not possible to determine the magnitude of the safety risk involved. Based on the most frequent categories of DRPs, there were risks of insufficient effect, unintended effects and, to a lesser extent, inappropriate self-medication.   Type: Original Research

scholarly journals Public perception of community pharmacists in South Africa: a preliminary study

2006 ◽  
Vol 11 (3) ◽  
Author(s):  
Suzanne Bornman ◽  
Ilse Truter ◽  
Daniel JL Venter
Keyword(s):  
South Africa ◽  
Full Text ◽  
Public Perception ◽  
Community Pharmacists ◽  
Community Pharmacies ◽  
Self Medication ◽  
Over The Counter ◽  
Preliminary Study

This survey forms part of a study undertaken to identify and quantify the community pharmacist’s involvement in the use of non-prescription/over-the-counter (OTC) medicine/self-medication in community pharmacies throughout South Africa. Opsomming Hierdie opname vorm deel van ‘n studie wat onderneem word om die gemeenskapsapteker se betrokkenheid in die gebruik van nie-voorskrif/oor-die-toonbank medikasie/ selfmedikasie in gemeenskapsapteke in Suid Afrika te identifiseer en te kwantifiseer. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

Women’s attitude toward gynecological pain in fertile age: Results from a cross-sectional study among Italian community pharmacies

2018 ◽  
Vol 10 (2) ◽  
pp. 88-94
Author(s):  
Corrado Giua Marassi ◽  
Assunta Pistone ◽  
Fabio Parazzini ◽  
Silvia Vannuccini ◽  
Felice Petraglia
Keyword(s):  
Medical Treatment ◽  
Pelvic Pain ◽  
Epidemiological Data ◽  
Cross Sectional Study ◽  
Community Pharmacies ◽  
Sectional Study ◽  
Self Medication ◽  
Cross Sectional ◽  
Mean Delay ◽  
Italian Community

Introduction: Several epidemiological data on women afferent to clinics for medical treatment of pelvic pain are available, while few studies explored the general population. Thus, this study aimed to investigate women presenting with gynecological pain at the community pharmacy and to evaluate the relevance of pharmacist advice regarding medical treatment. Methods: A cross-sectional study was conducted in a sample of 10 Italian community pharmacies, by administering a structured questionnaire to fertile age women reporting pelvic pain during the last 3 months. Questions were concerning demographic information, pain characteristics, women’s behavior toward gynecological pain, and diagnosis possibly received from a physician. Results: A group of 290 women were interviewed. Severe pain was reported in 58.3%, with a mean ± SD of 4.4 ± 6.8 days of suffering, causing absenteeism from work in 45.3% of cases. Almost half of women reported that the onset of gynecological pain was before 15 years and 72.2% had consulted a physician in the past, with a mean delay of 2.5 ± 4.3 years between the onset of pain and medical consultation. However, only 28% of the overall population received a diagnosis. 51.0% received one treatment, while 39% received two or more. The first therapy was prescribed in 40.2% cases by the physician, while in the remaining it was recommended either by the pharmacist or it was a self-medication. Conclusion: Gynecological pelvic pain is a disabling problem, regardless of the underlying cause, with significant impact on social and working life and requiring a better medical management.

Children Living in Poverty: Their Perception of Career Opportunities

1998 ◽  
Vol 79 (3) ◽  
pp. 320-330 ◽  
Author(s):  
Susan Weinger
Keyword(s):  
African Americans ◽  
Qualitative Study ◽  
Career Path ◽  
Growing Up ◽  
Middle Income ◽  
Projective Techniques ◽  
The Poor ◽  
Career Opportunities ◽  
Job Opportunities ◽  
Poor Children

Growing up in poverty often diminishes a child's opportunity to pursue a rewarding career path. This qualitative study explored whether poor children are aware that their wealthier peers' chances for success may be greater than their own. Projective techniques employing photographs of two houses representing poor and middle-income families were used to interview twenty-four children between the ages of five and thirteen years, divided equally between white and African Americans. These respondents perceived that society provides better future job opportunities to nonpoor children while limiting those of the poor. Although respondents suggested that they and their friends could be exceptions to these limitations, indications of their beginning feelings of hopelessness were revealed. The author proposes strategies to assist in strengthening poor children's belief in themselves and their future.

scholarly journals The management of upper gastrointestinal symptoms: A study on community pharmacies in Italy

Pharmacia ◽  
2021 ◽  
Vol 68 (2) ◽  
pp. 401-409
Author(s):  
Enrico Keber ◽  
Paolo Rocco ◽  
Umberto M. Musazzi ◽  
Antonio M. Morselli-Labate ◽  
Nicolina P. Floris ◽  
...  
Keyword(s):  
Gastrointestinal Symptoms ◽  
Cross Sectional Study ◽  
Community Pharmacies ◽  
Medication History ◽  
Self Medication ◽  
Cross Sectional ◽  
Therapeutic Class ◽  
Gi Symptoms ◽  
History Of ◽  
Upper Gastrointestinal

Upper gastrointestinal (GI) symptoms are usual complaints among patients presenting to Italian community pharmacies. However, information on treatment history of those patients is often lacking. This descriptive, cross-sectional study aims at exploring the medication history of individuals with upper GI tract symptoms visiting one of the 20 enrolled community pharmacies, over a period of 7 months, based on the administration of a questionnaire. Of 1,020 interviewees, 62.1% had asked for a medical consultation. The most frequent symptom was epigastric burning (31.8%), followed by acid regurgitation (14.6%) and post-prandial fullness (12.0%). Of the 1,609 therapies, proton pump inhibitors constituted the most represented therapeutic class (35.6%) followed by antacids (17.5%) and alginate-based products (17.2%). In treating symptoms, 38.1% of the patients do not seek medical advice, while 42.0% rely on non-prescription therapies. As findings suggest, support to patients with GI disorders in community pharmacies can be enhanced for a safer self-medication.

scholarly journals Drug shops for stronger health systems: learning from initiatives in six LMICs

2021 ◽  
Vol 14 (S1) ◽  
Author(s):  
Geetanjali Lamba ◽  
Zubin Cyrus Shroff ◽  
Zaheer-Ud-Din Babar ◽  
Abdul Ghaffar
Keyword(s):  
Case Studies ◽  
Health Systems ◽  
Access To Medicines ◽  
Health System Strengthening ◽  
Essential Medicines ◽  
Middle Income ◽  
Positive Attitudes ◽  
Drug Shops ◽  
Client Pressure ◽  
High Level

Abstract Background Private sector retail pharmacies, or drug shops, play an important role in access to essential medicines and services in low-and-middle-income countries. Recognising that they have the potential to contribute to health system strengthening efforts, many recent initiatives to engage with drug shops have been launched. These include initiatives that focus on changes in policy, regulation and training. However, the specific factors that influence their success remain poorly understood. Seven country case studies supported under the Alliance’s programme of work ‘Strengthening health systems: the role of drug shops’ help to explore this issue. Methods Country case studies from the above programme of research from Bangladesh, Indonesia, Myanmar, Nigeria, Tanzania and Zambia were used as the main sources of data for this paper. A modified version of Bigdeli et al.’s Access to Medicines framework was applied within a partially grounded approach to analyze each country case study and compare themes between countries. Results Many factors may help initiatives targeting drug shops successfully achieve their intended outcomes. At the micro level, these include community demand for drug shops and a positive relationship between drug shops and their clients. At the meso level, facilitators of initiative success include training and positive attitudes from drug shops towards the initiative. Barriers include client pressure, procurement challenges and financial and administrative costs associated with initiatives. At the macro level, collaboration between stakeholders, high-level buy in and supervision, monitoring and regulation may influence initiative success. These factors are inter-dependent and interact with each other in a dynamic way. Conclusions Using a framework approach, these country case studies demonstrate common factors that influence how drug shops can strengthen health systems. These learnings can help inform the design and implementation of successful strategies to engage drug shops towards sustainable systems change.

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