Perspectives of pharmacy staff on dispensing subtherapeutic doses of antibiotics: a theory informed qualitative study
INTRODUCTION Very few studies have investigated pharmacists' views, experiences and practices regarding the use of antibiotics without prescription. This study aimed to explore through self-report and hypothetical scenarios what factors determine New Zealand pharmacists' behaviour and attitudes towards non-prescription use of antibiotics. METHODS A purposeful sample of 35 registered community pharmacists of differing ethnic backgrounds was selected from a mixture of pharmacies that predominantly either serve New Zealand European customers or customers of other ethnicities. Semi-structured interviews including general background questions and six hypothetical scenarios were used for the investigation. Pharmacists' ethnicity, education, years of experience, and customers' ethnicity may influence their views, experiences and practices regarding the use of antibiotics without prescription. Customer demand or expectation, business orientation and competitiveness within community pharmacies, standards and practice of fellow pharmacists, ethics and professionalism, legislation, enforcement of the legislation, and apprehension of the consequences of such practice were hypothesised to have an effect on antibiotic use or supply without prescription by pharmacists. FINDINGS The supply of antibiotics without prescription is not common practice in New Zealand. However, personal use of antibiotics without prescription by pharmacists may have been underestimated. Pharmacists were aware of legalities surrounding selling and using antibiotics and practised accordingly, yet many used antibiotics without prescription to treat themselves and/or spouses or partners. Many pharmacists also reported that under certain legislative, and regulatory and situational conditions they would sell antibiotics without a prescription. CONCLUSION Views and practices regarding antibiotic use without prescription by community pharmacists require further exploration.