Magnitude and determinants of antibiotic dispensing without prescription in Spain: a simulated patient study

Objectives: Excessive and inappropriate use of antibiotics increases antimicrobial resistance. The aim of this study was to determine the magnitude and determinants of antibiotic dispensing without prescription in Spain by the simulated patient technique. Methods: A cross-sectional study was conduct...

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Autores: Zapata-Cachafeiro, M., Piñeiro-Lamas, M., Guinovart, M. C., López-Vázquez, P., Vázquez-Lago, J. M., Figueiras Guzmán, Adolfo
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Servizo Galego de Saúde (SERGAS)
Repositorio:RUNA. Repositorio da Consellería de Sanidade e Sergas
OAI Identifier:oai:runa.sergas.gal:20.500.11940/15510
Acceso en línea:https://www.ncbi.nlm.nih.gov/pubmed/30395222
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6337896/pdf/dky440.pdf
http://hdl.handle.net/20.500.11940/15510
Access Level:acceso abierto
Palabra clave:CHUS
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spelling Magnitude and determinants of antibiotic dispensing without prescription in Spain: a simulated patient studyZapata-Cachafeiro, M.Piñeiro-Lamas, M.Guinovart, M. C.López-Vázquez, P.Vázquez-Lago, J. M.Figueiras Guzmán, AdolfoCHUSIDISObjectives: Excessive and inappropriate use of antibiotics increases antimicrobial resistance. The aim of this study was to determine the magnitude and determinants of antibiotic dispensing without prescription in Spain by the simulated patient technique. Methods: A cross-sectional study was conducted with all the pharmacies in a region of north-west Spain (n = 977), between December 2016 and January 2017. Four actors visited the pharmacies simulating a respiratory infection. Four incremental levels of pressure were used to obtain an antibiotic. The education and sex of the person who was dispensing and the area where the pharmacy was located were recorded. The effect of these independent variables on the dispensing of an antibiotic without prescription (1 = yes, 0 = no) was modelled by logistic regression. Results: An antibiotic was obtained in 18.83% (95% CI = 16.5%-21.41%) of the visits. The area influenced the dispensing of antibiotics without a medical prescription, with a greater likelihood of dispensing in rural (OR = 1.79; 95% CI = 1.20-2.68) or semi-rural (OR = 1.66; 95% CI = 1.13-2.44) areas than in urban areas. No association was found with the sex or the training of the person who dispensed the antibiotic. In the pharmacies in urban areas, a lower level of pressure was needed to obtain the antibiotic. Conclusions: This study shows that one-fifth of the pharmacies still dispense antibiotics without prescription, especially under patient pressure. A rural setting has been identified as a risk factor for dispensing without prescription, so it must be taken into account for future interventions.2019info:eu-repo/semantics/articlehttps://www.ncbi.nlm.nih.gov/pubmed/30395222https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6337896/pdf/dky440.pdfhttp://hdl.handle.net/20.500.11940/15510reponame:RUNA. Repositorio da Consellería de Sanidade e Sergasinstname:Servizo Galego de Saúde (SERGAS)Ingléshttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:runa.sergas.gal:20.500.11940/155102026-06-12T08:40:47Z
dc.title.none.fl_str_mv Magnitude and determinants of antibiotic dispensing without prescription in Spain: a simulated patient study
title Magnitude and determinants of antibiotic dispensing without prescription in Spain: a simulated patient study
spellingShingle Magnitude and determinants of antibiotic dispensing without prescription in Spain: a simulated patient study
Zapata-Cachafeiro, M.
CHUS
IDIS
title_short Magnitude and determinants of antibiotic dispensing without prescription in Spain: a simulated patient study
title_full Magnitude and determinants of antibiotic dispensing without prescription in Spain: a simulated patient study
title_fullStr Magnitude and determinants of antibiotic dispensing without prescription in Spain: a simulated patient study
title_full_unstemmed Magnitude and determinants of antibiotic dispensing without prescription in Spain: a simulated patient study
title_sort Magnitude and determinants of antibiotic dispensing without prescription in Spain: a simulated patient study
dc.creator.none.fl_str_mv Zapata-Cachafeiro, M.
Piñeiro-Lamas, M.
Guinovart, M. C.
López-Vázquez, P.
Vázquez-Lago, J. M.
Figueiras Guzmán, Adolfo
author Zapata-Cachafeiro, M.
author_facet Zapata-Cachafeiro, M.
Piñeiro-Lamas, M.
Guinovart, M. C.
López-Vázquez, P.
Vázquez-Lago, J. M.
Figueiras Guzmán, Adolfo
author_role author
author2 Piñeiro-Lamas, M.
Guinovart, M. C.
López-Vázquez, P.
Vázquez-Lago, J. M.
Figueiras Guzmán, Adolfo
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv CHUS
IDIS
topic CHUS
IDIS
description Objectives: Excessive and inappropriate use of antibiotics increases antimicrobial resistance. The aim of this study was to determine the magnitude and determinants of antibiotic dispensing without prescription in Spain by the simulated patient technique. Methods: A cross-sectional study was conducted with all the pharmacies in a region of north-west Spain (n = 977), between December 2016 and January 2017. Four actors visited the pharmacies simulating a respiratory infection. Four incremental levels of pressure were used to obtain an antibiotic. The education and sex of the person who was dispensing and the area where the pharmacy was located were recorded. The effect of these independent variables on the dispensing of an antibiotic without prescription (1 = yes, 0 = no) was modelled by logistic regression. Results: An antibiotic was obtained in 18.83% (95% CI = 16.5%-21.41%) of the visits. The area influenced the dispensing of antibiotics without a medical prescription, with a greater likelihood of dispensing in rural (OR = 1.79; 95% CI = 1.20-2.68) or semi-rural (OR = 1.66; 95% CI = 1.13-2.44) areas than in urban areas. No association was found with the sex or the training of the person who dispensed the antibiotic. In the pharmacies in urban areas, a lower level of pressure was needed to obtain the antibiotic. Conclusions: This study shows that one-fifth of the pharmacies still dispense antibiotics without prescription, especially under patient pressure. A rural setting has been identified as a risk factor for dispensing without prescription, so it must be taken into account for future interventions.
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://www.ncbi.nlm.nih.gov/pubmed/30395222
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6337896/pdf/dky440.pdf
http://hdl.handle.net/20.500.11940/15510
url https://www.ncbi.nlm.nih.gov/pubmed/30395222
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6337896/pdf/dky440.pdf
http://hdl.handle.net/20.500.11940/15510
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv reponame:RUNA. Repositorio da Consellería de Sanidade e Sergas
instname:Servizo Galego de Saúde (SERGAS)
instname_str Servizo Galego de Saúde (SERGAS)
reponame_str RUNA. Repositorio da Consellería de Sanidade e Sergas
collection RUNA. Repositorio da Consellería de Sanidade e Sergas
repository.name.fl_str_mv
repository.mail.fl_str_mv
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