Assessment of Awareness and Appropriate Behavioural Measures of Community Pharmacists Towards Antimicrobial Stewardship: A Cross-Sectional Questionnaire-Based Survey.
Abstract
Abstract Introduction: The increasing problem of antimicrobial resistance (AMR) is one of the major challenges to public health and is largely due to the misuse of antimicrobials. Community Pharmacists (CPs) are vital in antimicrobial dispensing and AMS practice. This study sought to explore AMR awareness, practices, barriers, and associated determinants among CPs in Odisha, India. Methodology: A cross-sectional study was conducted among registered community pharmacists in Cuttack district. Out of 135 questionnaires distributed, 108 usable questionnaires were analyzed using a 38-item questionnaire including awareness/perceptions (12 items), dispensing practices (18 items), and barriers (8 items). I-CVI, scale-level CVI, Lawshe’s CVR, and Cronbach’s alpha were used for content validity and reliability, respectively. Logistic regression analysis was carried out to identify determinants of AMS practice adoption. Results: The majority of the participants were male (81.5%; n = 88) and had obtained a D.Pharm degree (61.1%; n = 66). Uninformed, inactive adopters, and those with high perceived barriers were 52.8% (n = 57), 55.6% (n = 60), and 61.1% (n = 66), respectively. About half (47.2%; n = 51) of the study population dispensed >60 antimicrobials per month without prescriptions. The I-CVI for all constructs was found to be 1.00. The alpha values of the awareness/perception and dispensing practice scales were 0.731 and 0.793, respectively. Increased years of experience among pharmacists were significantly associated with increased odds of being inactive AMS adopters (adjusted OR = 1.237; 95% CI: 1.016–1.505; p = 0.034). Nevertheless, the whole regression model was not significant (χ² = 11.585; df = 11; p = 0.396). Conclusion: There exist notable deficits in AMS awareness and practices, high perceived barriers and non-prescription dispensing which warrant interventions on the part of pharmacists. Generalizability: Findings mainly represent community pharmacists from one district but are indicative of similar contexts in Odisha and India at large.