The impact of a multi-faceted intervention on non-prescription dispensing of antibiotics by urban community pharmacies in Indonesia: a mixed methods evaluation

作者：Astri Ferdiana, Yusuf Ari Mashuri, Luh Putu Lila Wulandari, Ihsanti Dwi Rahayu, Miratul Hasanah, Zulfa Ayuningsih, Neha Batura, Mishal Khan, Marco Liverani, Rebecca Guy, Gill Schierhout, John Kaldor, Matthew Law, Richard O. Day, Stephen Jan, Tri Wibawa, Ari Probandari, Shunmay Yeung, Virginia Wiseman · 发表于：BMJ Global Health · 年份：2024 · DOI：10.1136/bmjgh-2024-015620 · 被引用次数：9 · 研究领域：Antibiotic Use and Resistance、Pharmaceutical Quality and Counterfeiting、Pharmaceutical Economics and Policy

Introduction Non-prescription antibiotic dispensing is prevalent among community pharmacies in several low- and middle-income countries. We evaluated the impact of a multi-faceted intervention to address this challenge in urban community pharmacies in Indonesia. Methods A pre-post quasi-experimental study was carried out in Semarang city from January to August 2022 to evaluate a 7-month long intervention comprising: (1) online educational sessions for pharmacists; (2) awareness campaign targeting customers; (3) peer visits; and (4) pharmacy branding and pharmacist certification. All community pharmacies were invited to take part with consenting pharmacies assigned to the participating group and all remaining pharmacies to the non-participating group. The primary outcome (rate of non-prescription antibiotic dispensing) was measured by standardised patients displaying symptoms of upper respiratory tract infection, urinary tract infection (UTI) and seeking care for diarrhoea in a child. χ 2 tests and multivariate random-effects logistic regression models were conducted. Thirty in-depth interviews were conducted with pharmacists, staff and owners as well as other relevant stakeholders to understand any persistent barriers to prescription-based dispensing of antibiotics. Findings Eighty pharmacies participated in the study. Postintervention, non-prescription antibiotics were dispensed in 133/240 (55.4%) consultations in the participating group compared with 469/570 (82.3%) in the ...