Exploring the reasons why pharmacists dispense antibiotics without prescriptions in Khartoum state, Sudan.

Abstract

The principal aim of this study was to explore the perspectives of community pharmacists in Khartoum State, Sudan about why they dispense antibiotics without prescription, and to understand their opinions about why they think patients self-medicate. This was a qualitative exploratory interview study. Individual, in-depth face-to-face interviews were conducted with a convenience sample of 30 community pharmacists working in Khartoum State, Sudan in the period from May to June 2015. Each interview was recorded, transcribed, anonymized and coded into themes. Thematic analysis was carried out. The study revealed that patients' inability to afford consultation fees is the key reason that leads community pharmacists to dispense antibiotics without prescriptions. Other reasons include inaccessible health facilities and long waiting time for consultation, patient being familiar with the symptoms and had previously responded to antibiotic treatment, lack of monitoring of dispensing practices by health authority, commercial interest of pharmacists, blurred professional boundaries between pharmacists and doctors in patients' minds, and lack of pharmacists care regarding educating patients about the impact of self-medication. Although different reasons were identified that lead pharmacists to dispense antibiotics without prescription, patients' inability to afford consultation fees remains the key one. It is crucial to address this problem. Improving the accessibility and quality of governmental health facilities, increasing public and pharmacists' awareness about the risks of self-medication and monitoring the dispensing practices at community pharmacies by health authorities are also important.