Knowledge, Attitudes, Motivations, Expectations, and Systemic Factors Regarding Antimicrobial Use Amongst Community Members Seeking Care at the Primary Healthcare Level: A Scoping Review

Antibiotics, Journal Year: 2025, Volume and Issue: 14(1), P. 78 - 78

Published: Jan. 13, 2025

Background/Objectives: Antimicrobial resistance (AMR) is a major global health challenge, particularly in low- and middle-income countries (LMICs). Understanding the knowledge, attitudes, motivations, expectations of community members regarding antimicrobial use essential for effective stewardship interventions. This scoping review aimed to identify key themes relating critical areas among primary healthcare (PHC), with particular focus on LMICs. Methods: OVID Medline, PubMed, CINAHL databases were searched using Boolean operators Medical Subject Headings (MeSH) terms relevant behaviors. The Population, Intervention, Comparison, Outcome, Study Design (PICOS) framework guided study selection, which focused seeking care PHC Data management extraction facilitated Covidence platform, Critical Appraisal Skills Programme (CASP) qualitative checklist applied studies. A narrative synthesis identified grouped sub-themes. Results: search 497 sources, 59 met inclusion criteria, 75% studies conducted outpatient settings. Four identified: (1) ’patient’ theme, highlighting beliefs, expectations, was most prominent (40.5%); (2) ’provider’ emphasizing challenges related clinical decision-making, knowledge gaps, adherence guidelines; (3) ’healthcare systems’ resource limitations, lack infrastructure, policy constraints; (4) ‘intervention/uptake’ strategies improve future antibiotic enhance access quality healthcare. Conclusions: Stewardship programs settings LMICs should be designed context-specific, community-engaged, accessible individuals varying levels understanding, involving information literacy effectively reduce AMR.

Language: Английский

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Community antibiotic consumption and associated factors in Lusaka district of Zambia: findings and implications for antimicrobial resistance and stewardship

JAC-Antimicrobial Resistance, Journal Year: 2024, Volume and Issue: 6(2)

Published: March 5, 2024

Antimicrobial resistance (AMR) is a global public health crisis. This study assessed the general public's consumption of antibiotics and associated factors in Lusaka district Zambia.

Language: Английский

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Potential Strategies to Limit Inappropriate Purchasing of Antibiotics without a Prescription in a Rural Province in South Africa: Pilot Study and the Implications

Advances in Human Biology, Journal Year: 2024, Volume and Issue: 14(1), P. 60 - 67

Published: Jan. 1, 2024

Introduction: There is considerable concern with rising rates of antimicrobial resistance (AMR) its subsequent impact on morbidity, mortality and costs. In low- middle-income countries, a key driver AMR the appreciable misuse antibiotics in ambulatory care, which can account for up to 95% human utilisation. A principal area selling without prescription. conflicting evidence South Africa regarding this practice alongside rates. Consequently, there need explore further, especially more rural areas Africa. pilot study was undertaken address this. Materials Methods: two-step descriptive approach involving self-administered questionnaire amongst pharmacists their assistants followed by cognitive interviews some participants. Results: Twenty-one responses were obtained from nine 11 community pharmacies invited participate. Participating all independently owned. Ten 21 participants admitted dispensing prescription, including both adults children, representing five participating pharmacies. minority dispensed before recommending suitable over-the-counter medicines. These high exacerbated patient pressure. issues length phraseology, will be addressed main study. Conclusion: concerns extent purchasing prescription Key explored further

Language: Английский

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Knowledge, attitudes, motivations and expectations regarding antimicrobial use among community members seeking care at the primary healthcare level: a scoping review protocol

BMJ Open, Journal Year: 2025, Volume and Issue: 15(1), P. e088769 - e088769

Published: Jan. 1, 2025

Introduction Inappropriate antibiotic use in (primary healthcare, PHC) settings fuels antimicrobial resistance (AMR), threatens patient safety and burdens healthcare systems. Patients’ knowledge, attitudes, motivations expectations play a crucial role behaviour, especially low-income middle-income countries including South Africa. There is need to ensure measures of use, interventions future guidance reflect cultural, community demographic issues associated with views reduce inappropriate antibiotics AMR. The objective this scoping review identify key themes surrounding among patients members regarding PHC countries. Methods analysis This employs comprehensive search strategy across multiple electronic databases, OVID, Medline, PubMed CINHAL, studies addressing or seeking care at facilities exploring drivers use. Covidence web-based platform will be used for literature screening data extraction the Critical Appraisal Skills Programme qualitative checklist assess quality papers. Anticipated results provide an overview current evidence base, enabling identification knowledge gaps. A narrative synthesis findings summarise patterns patients’ related while considering methodological diversity limitations. Ethics dissemination approval not required review. disseminated through publication peer-reviewed journal, presentation relevant conferences workshops, collaboration policy-makers stakeholders.

Language: Английский

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Pilot Study to Evaluate Patients’ Understanding of Key Terms and Aspects of Antimicrobial Use in a Rural Province in South Africa Findings and Implications

Advances in Human Biology, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 9, 2024

Abstract Introduction: Antimicrobial resistance (AMR) is a global concern, necessitating the understanding of utilisation patterns and their rationale. Pilot studies have been conducted in rural province South Africa to determine extent self-purchasing antibiotics by patients from independent chain pharmacies. It imperative understand knowledge concerns regarding key aspects antibiotic use AMR, potential language barriers, when pharmacists assistants are discussing with patients. Consequently, aim was pre-test patient questionnaire translated three native languages building on findings English pilot. Materials Methods: The (Parts 1 2) Sepedi, Tshivenda Xitsonga. In total 30 were interviewed (5/language for Part 2 respectively) leaving 10 This followed interviews evaluate questions concepts. Results: Eleven 15 received antibiotics, including 8 without prescription. Only pharmacies (8/10) dispensed prescriptions. Interviews revealed about AMR that certain terms ‘antibiotic’ ‘AMR’ posed challenges purpose antibiotics. For instance, one self-purchased ‘cleansing’ sexually transmitted infections. questionnaires subsequently revised so explanations terms, will be provided main study. Conclusion: Similar previous pilot studies, observed among pharmacies, although at varying rates, similar indications. Continued health literacy education patients, especially communication, needed address current explored

Language: Английский

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Hospital prescribing patterns of antibiotics in Zambia using the WHO prescribing indicators post-COVID-19 pandemic: findings and implications

JAC-Antimicrobial Resistance, Journal Year: 2023, Volume and Issue: 6(1)

Published: Dec. 28, 2023

Antimicrobial resistance (AMR) is a global public health problem that fuelled by the inappropriate prescribing of antibiotics, especially those from 'watch' and 'reserve' antibiotic lists. The irrational antibiotics particularly prevalent in developing countries, including Zambia. Consequently, there need to better understand patterns across sectors Zambia as basis for future interventions. This study evaluated using WHO indicators alongside 'access, watch reserve' (AWaRe) classification system post-COVID pandemic at faith-based hospital

Language: Английский

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A Narrative Review of Recent Antibiotic Prescribing Practices in Ambulatory Care in Tanzania: Findings and Implications

Medicina, Journal Year: 2023, Volume and Issue: 59(12), P. 2195 - 2195

Published: Dec. 18, 2023

Background and objectives: There are concerns with the current prescribing practices of antibiotics in ambulatory care Tanzania, including both public private sectors. These need to be addressed as part national action plan (NAP) Tanzania reduce rising antimicrobial resistance (AMR) rates. Issues include high rates for essentially self-limiting conditions. Consequently, there is a address this. As result, aims this narrative review were comprehensively summarize antibiotic utilization patterns particularly their rationale suggest ways forward improve future practices. Materials Methods: We undertook recently published studies subsequently documented potential activities Potential included instigating quality indicators stewardship programs (ASPs). Results: Published have shown that being excessively prescribed up 95% 96.3% presenting cases depending on sector. This despite appropriateness. High not helped by variable adherence treatment guidelines. also been extensive 'Watch' Overall, majority across sectors, albeit inappropriately, typically from 'Access' group AWaRe (Access/Watch/Reserve) classification rather than limit AMR. The inappropriate linked knowledge regarding antibiotics, AMR, ASPs among prescribers patients. Recommended improved education all groups, instigation updated indicators, regular monitoring against agreed-upon guidelines indicators. Education healthcare professionals should start at undergraduate level continue post qualification. Community advocacy rational use social media dispel misinformation. Conclusion: sub-optimal Tanzania. needs urgently addressed.

Language: Английский

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Pilot Study to Evaluate the Feasibility of a Patient Questionnaire for the Purpose of Investigating the Extent of Purchasing Antibiotics without a Prescription in a Rural Province in South Africa: Rationale and Implications

Advances in Human Biology, Journal Year: 2024, Volume and Issue: 14(2), P. 138 - 147

Published: March 5, 2024

Abstract Introduction: There are concerns with rising rates of antimicrobial resistance (AMR) across countries appreciable impact on morbidity, mortality and costs. Amongst low- middle-income countries, a key driver AMR is the excessive use antibiotics in ambulatory care, critical area being selling without prescription often driven by patient demand limited knowledge. currently conflicting evidence South Africa regarding this practice. Consequently, there need to explore these issues amongst patients, especially more rural areas Africa. A pilot study was undertaken address this. Methods: two-step descriptive approach undertaken. This involved two questionnaires patients exiting chain independent community pharmacies followed cognitive interviews. Results: Overall, 21 were approached for an interview, including 11 Part 1 questionnaire 3 declining, 10 2, 2 declining. Subsequently 8 completed each part questionnaire. On average, it took min 13 s complete both parts. 5 dispensed antibiotic one prescription, all from pharmacies. Key reasons self-purchasing included money convenience. mixed knowledge interviewed 2. satisfactory understanding questions, although some modifications suggested. Some participants had difficulty fully questions number suggestions made improve main study. Conclusion: extent purchasing as well AMR. Both addressing will be explored further

Language: Английский

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Assessment of rational antibiotic use among children being treated in primary care facilities in Punjab, Pakistan: findings and implications

Drugs & Therapy Perspectives, Journal Year: 2024, Volume and Issue: 40(4), P. 160 - 171

Published: April 1, 2024

Language: Английский

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A comprehensive outline of antimicrobial resistance, antibiotic prescribing, and antimicrobial stewardship in South Africa: A scoping review protocol

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(1), P. e0316718 - e0316718

Published: Jan. 27, 2025

Introduction The global prevalence of antimicrobial resistance transcends geographical and economic boundaries, affecting populations worldwide. Excessive incorrect use antibiotics encourages which leads to complex treatment strategies for infectious diseases possible failure treatment. unnecessary prescribing places a burden on healthcare costs thus, is evident globally as major public health concern. impact particularly pronounced in low middle-income countries, where limited access exacerbates the crisis. This scoping review aims comprehensively map evidence settings, encompassing exploration antibiotic practices implementation stewardship initiatives South Africa. Methodology protocol has been registered Open Science Framework ( https://doi.org/10.17605/OSF.IO/PWMFB ). will consider all types study designs, conducted within Studies that are published English period 2019–2024, explore (AMR) Africa, including trends surveillance be included. Non-English publications, studies outside animal environmental excluded. criteria set by two reviewers. Preferred Reporting Items Systematic Reviews Meta-Analyses Scoping (PRISMA-ScR) tool used. identified through an extensive search peer-reviewed grey literature databases. results tabulated include narrative synthesis findings.

Language: Английский

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