Pharmacists’ practices for non-prescribed antibiotic dispensing in Mozambique
Main Article Content
Keywords
Anti-Bacterial Agents, Self Medication, Prescriptions, Pharmacists, Professional Practice, Pharmacies, Drug Resistance, Bacterial, Motivation, Law Enforcement, Public Health, Qualitative Research, Mozambique
Abstract
Background: Antibiotics are the most frequently used medicines worldwide with most of the countries defining these as prescription-only medicines. Though, dispensing non-prescribed antibiotics represent one of the chief causal factors to the irrational use of antibiotics that paves the way to the development of antimicrobial resistance.
Objective: We aimed at describing the practices and the enablers for non-prescribed antibiotic dispensing in Maputo city, Mozambique.
Methods: A qualitative study was conducted, between October 2018 and March 2019, in nine private pharmacies randomly selected across Maputo city. Eighteen pharmacists were contacted and seventeen enrolled through snowball sampling. In-depth interviews were conducted, audiotaped, and transcribed verbatim. Transcripts were coded and analysed though thematic analysis with guidelines from Braun and Clark. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist by (Tong, 2007) was performed.
Results: Out of seventeen, fifteen pharmacists admitted non-prescribed dispensing of antibiotics. Common antibiotic dispensing practices included; dispensing without prescription, without asking for a brief clinical history of patients, without clear explanation of the appropriate way of administering, without advising on the side effects. Reasons for non-prescribed antibiotic dispensing are linked to patients’ behaviour of demanding for non-prescribed antibiotics, to the patients expectations and beliefs on the healing power of antibiotics, to the physicians’ prescribing practices. Other reasons included the pressure for profits from the pharmacy owners, the fragile law enforcement, and absence of accountability mechanisms.
Conclusions: The practices of non-prescribed antibiotic dispensing characterize the ‘daily life’ of the pharmacists. On the one hand, the patient’s demand for antibiotics without valid prescriptions, and pharmacist’s wish to assist based on their role in the pharmacy, the pressure for profits and on the understanding of the larger forces driving the practices of self-medication with antibiotics - rock. On the other hand, pharmacists are aware of the legal status of antibiotics and the public health consequences of their inappropriate dispensing practices and their professional and ethical responsibility for upholding the law - hard place. Highlighting the role of pharmacists and their skills as health promotion professionals is needed to optimizing antibiotic dispensing and better conservancy in Mozambique.
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12. Zajmi D, Berisha M, Begolli I, Hoxha R, Mehmeti R, Mulliqi-Osmani G, Kurti A, Loku A, Raka L. Public knowledge, attitudes and practices regarding antibiotic use in Kosovo. Pharm Pract (Granada). 2017;15(1):827. https://doi.org/10.18549/pharmpract.2017.01.827
13. Al-Kubaisi KA, De Ste Croix M, Vinson D, Sharif SI, Abduelkarem AR. What drives using antibiotic without prescriptions? A qualitative interview study of university students in United Arab Emirates. Pharm Pract (Granada). 2018;16(2):1172. https://doi.org/10.18549/pharmpract.2018.02.1172
14. Jakupi A, Raka D, Kaae S, Sporrong SK. Culture of antibiotic use in Kosovo - an interview study with patients and health professionals. Pharm Pract (Granada). 2019;17(3):1540. https://doi.org/10.18549/pharmpract.2019.3.1540
15. Mansour H, Feghali M, Saleh N, Zeitouny M. Knowledge, practice and attitudes regarding antibiotics use among Lebanese dentists. Pharm Pract (Granada). 2018;16(3):1272. https://doi.org/10.18549/pharmpract.2018.03.1272
16. Bahnassi A. A qualitative analysis of pharmacists' attitudes and practices regarding the sale of antibiotics without prescription in Syria. J Taibah Univ Med Sci, 2015. 10(2):227-233. https://doi.org/10.1016/j.jtumed.2014.09.001
17. Bahnassi A. Pharmacists Views and Practices in Regard to Sales of Antibiotics Without a Prescription in Madinah, Saudi Arabia. J Patient Saf. 2016;12(3):159-164. https://doi.org/10.1097/pts.0000000000000087
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19. Sawalha AF. A descriptive study of self-medication practices among Palestinian medical and nonmedical university students. Res Social Adm Pharm. 2008;4(2):164-172. https://doi.org/10.1016/j.sapharm.2007.04.004
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21. Afolabi AO. Factors influencing the pattern of self-medication in an adult Nigerian population. Ann Afr Med. 2008;7(3):120-127. https://doi.org/10.4103/1596-3519.55666
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Pharmacists’ practices for non-prescribed antibiotic dispensing in Mozambique. Pharm Pract (Granada) [Internet]. 2020 Aug. 18 [cited 2024 Sep. 12];18(3):1965. Available from: https://www.pharmacypractice.org/index.php/pp/article/view/1965
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Pharmacists’ practices for non-prescribed antibiotic dispensing in Mozambique. Pharm Pract (Granada) [Internet]. 2020 Aug. 18 [cited 2024 Sep. 12];18(3):1965. Available from: https://www.pharmacypractice.org/index.php/pp/article/view/1965