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Patterns of self-medication with antibiotics in Maputo City: a qualitative study
Neusa F Torres1,2, Vernon P Solomon3, Lyn E Middleton3
11Instituto Superior de Ciências de Saúde (ISCISA), High Institute for Health Sciences, Maputo, Mozambique.
Background:
Mozambique classifies but does not yet enforce antibiotics as prescription-only-medicine (POM) allowing the public access to a variety of antibiotics that otherwise are provided on prescription. This contributes to the growing practice of self-medication with antibiotics (SMA) which systematically exposes individuals to the risk of developing antibiotic resistance, antibiotic side effects and increases the health service costs and morbidity. This study aimed at describing the patterns of SMA among Maputo city pharmacy customers.
Methods:
A qualitative study conducted between October 2018 and March 2019 was developed with thirty-two pharmacy customers and seventeen pharmacists. Using convenience sampling, customers were recruited after buying antibiotics without prescription from nine private pharmacies. Of the thirty-two participants, twenty participated in in-depth interviews and twelve in two focus groups discussions (FGD) with six participants each. Purposive sampling and a snowball technique were used to recruit pharmacists. The transcripts were coded and analyzed using latent content analysis. Nvivo 11 was used to store and retrieve the data. The COREQ (Tong, 2007) checklist for interviews and FGD was performed.
Results:
Customers admitted practices of SMA, pharmacists admitted dispensing a variety of antibiotics without prescription. Non-prescribed antibiotics (NPA) were obtained through five different patterns including; using the generic name, describing the physical appearance and using empty package, describing symptoms or health problem to pharmacists, using old prescriptions and sharing antibiotics with family, friends, and neighbors.
Conclusion:
Different patterns of SMA are contributing to the indiscriminate use of antibiotics among customers. The NPA utilization is perceived as an expression of self-care where participants experience self-perceived symptoms and indulge in self-treatment as a method of caring for themselves. Moreover, antibiotics are mostly used to treat diseases that do not necessarily need antibiotics. Strong and effective public health education and promotion initiatives should be implemented to discourage inappropriate utilization of antibiotics and SMA practices.
Insights
Self-medication with antibiotics is common in Mozambique due to weak prescription regulations. This practice leads to risks like antibiotic resistance and increased health costs, highlighting the need for public health education.
Area of Science:
- Public Health
- Pharmacology
- Infectious Diseases
Background:
- Mozambique's classification of antibiotics as prescription-only-medicine (POM) is not enforced, allowing public access.
- This contributes to widespread self-medication with antibiotics (SMA), increasing risks of antibiotic resistance, side effects, and healthcare costs.
Purpose of the Study:
- To describe the patterns of self-medication with antibiotics (SMA) among customers in Maputo city pharmacies.
Main Methods:
- A qualitative study involving 32 pharmacy customers and 17 pharmacists in Maputo.
- Data collected through in-depth interviews and focus group discussions (FGD) between October 2018 and March 2019.
- Latent content analysis was used to analyze coded transcripts, with NVivo 11 for data management.
Main Results:
- Customers admitted to SMA practices, and pharmacists acknowledged dispensing antibiotics without prescriptions.
- Non-prescribed antibiotics (NPA) were accessed through various methods: generic name, physical description, symptom description, old prescriptions, and sharing.
Conclusions:
- Identified SMA patterns contribute to indiscriminate antibiotic use, often perceived as self-care for self-diagnosed conditions.
- Antibiotics are frequently used for conditions not requiring them, emphasizing the need for public health education to curb inappropriate use.
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