Antimicrobial Resistance and Community Pharmacists' Perspective in Thailand: A Mixed Methods Survey Using Appreciative Inquiry Theory.

Rojjares Netthong,Ros Kane,Keivan Ahmadi

doi:10.3390/antibiotics11020161

Rojjares Netthong, Ros Kane + Show 1 more

Open Access

https://doi.org/10.3390/antibiotics11020161

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Journal: Antibiotics	Publication Date: Jan 27, 2022
Citations: 6	License type: CC BY 4.0

Affiliation: Ubon Ratchathani University, University of Lincoln

Abstract

Global action plans to tackle antimicrobial resistance (AMR) are the subject of ongoing discussion between experts. Community pharmacists have a professional responsibility to tackle AMR. This study aimed to evaluate the knowledge of antibiotic resistance and attitudes to promoting Antibiotic Smart Use (ASU) amongst part and full-time practicing community pharmacists across Thailand. An online mixed-method survey applying Appreciative Inquiry theory was validated and conducted in 2020. Non-probability sampling was used, with online survey dissemination via social networks. A total of 387 community pharmacists located in 59 out 77 provinces seemed knowledgeable about antimicrobial resistance (mean score = 82.69%) and had acceptable attitudes towards antibiotic prescribing practices and antimicrobial stewardship (mean score = 73.12%). Less than 13% of pharmacists had postgraduate degrees. Postgraduate education, training clerkship, preceptors, and antibiotic stewardship training positively affected their attitudes. The community pharmacists proposed solutions based on the Appreciative Inquiry theory to promote ASU practices. Among these were educational programmes consisting of professional conduct, social responsibility and business administration knowledge, up-to-date legislation, and substitutional strategies to compensate business income losses.

Highlights

Antimicrobial resistance (AMR) has been recognised as an imminent threat to the global healthcare systems and the United Nation’s (UN) sustainable development goals (SDGs) [1,2,3,4]
South East Asia has become the home to a number of upper middle-income economies such as Thailand [20,21], where economic development and the subsequent improvement of purchasing power, and the legal dispensing of antibiotics without a doctor’s prescription by community pharmacists, have together exacerbated the spread of AMR [8,13,14,15,16,17,22,23,24,25]
We present the quantitative and qualitative findings of our mixed method survey with a focus on exploring the factors that contribute to the current antibiotic dispensing practices amongst community pharmacists, whilst presenting the solutions proposed by the community pharmacists in regards to the four domains of the Appreciative Inquiry (AI) theory

Summary

Introduction

Antimicrobial resistance (AMR) has been recognised as an imminent threat to the global healthcare systems and the United Nation’s (UN) sustainable development goals (SDGs) [1,2,3,4]. Prescriber and patient behaviour, availability of antibiotics and legislation of antibiotics’ sale and advertising (which is forbidden in many other parts of the world), as well as rising incomes, are the main reasons for AMR in this region [18,19]. South East Asia has become the home to a number of upper middle-income economies such as Thailand [20,21], where economic development and the subsequent improvement of purchasing power, and the legal dispensing of antibiotics without a doctor’s prescription by community pharmacists, have together exacerbated the spread of AMR [8,13,14,15,16,17,22,23,24,25]. Following its success at the hospital level, the ASU programme was piloted among community pharmacists with a focus on screening for pharyngitis, a common upper respiratory tract infection, in 2017 [28]

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