"Arming half-baked people with weapons!" Information enclaving among professionals and the need for a care-centred model for antibiotic use information in Uganda, Tanzania and Malawi
"Arming half-baked people with weapons!" Information enclaving among professionals and the need for a care-centred model for antibiotic use information in Uganda, Tanzania and Malawi
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DOI：
10.1080/16549716.2024.2322839
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发表时间：
2024-12-31
影响因子：
2.6
通讯作者：
Chandler，Clare I. R.
中科院分区：
文献类型：
--
作者：
Nayiga，Susan;MacPherson，Eleanor E.;Chandler，Clare I. R.
过度使用抗微生物药物是一个全球卫生问题，包括作为抗微生物药物耐药性的主要驱动因素。在许多低收入和中等收入国家，很大一部分抗生素是在没有处方的情况下购买的非处方药。但是，虽然抗生素广泛可用，但关于何时以及如何使用它们的信息却不清楚。目的：我们旨在了解乌干达、坦桑尼亚和马拉维的专家和专业人员对与最终用户（患者、护理人员和农民）共享抗生素使用信息的接受程度。方法在对三个国家的最终用户和抗生素提供者进行长期实地调查的基础上，我们于2021年12月在每个国家举办了两次讲习班，共有44名医学和兽医专业人员、政策制定者和药品监管机构参加。我们进行了广泛的文献和文献综述，以表征每种情况下的抗生素信息系统。结果与会者报告说，在这三个国家，国家药品主管部门、卫生保健提供者和药品说明书向公众提供了有关药物使用的信息。与会者对共享抗生素使用详细信息的危险表示关切，特别是最终用户没有能力确定药物的适当使用。分享一般指示以鼓励专业规定的做法是可取的。结论如果不能很好地获得处方医师，知识封闭和知识共享之间的紧张关系就会出现公平问题。从患者、护理人员或农民的需求开始，向以客户为中心的模式过渡，将需要在护理点共享公正的抗生素信息。
BackgroundThe overuse of antimicrobial medicines is a global health concern, including as a major driver of antimicrobial resistance. In many low- and middle-income countries, a substantial proportion of antibiotics are purchased over-the-counter without a prescription. But while antibiotics are widely available, information on when and how to use them is not.ObjectiveWe aimed to understand the acceptability among experts and professionals of sharing information on antibiotic use with end users – patients, carers and farmers – in Uganda, Tanzania and Malawi.MethodsBuilding on extended periods of fieldwork amongst end-users and antibiotic providers in the three countries, we conducted two workshops in each, with a total of 44 medical and veterinary professionals, policy makers and drug regulators, in December 2021. We carried out extensive documentary and literature reviews to characterise antibiotic information systems in each setting.ResultsParticipants reported that the general public had been provided information on medicine use in all three countries by national drug authorities, health care providers and in package inserts. Participants expressed concern over the danger of sharing detailed information on antibiotic use, particularly that end-users are not equipped to determine appropriate use of medicines. Sharing of general instructions to encourage professionally-prescribed practices was preferred.ConclusionsWithout good access to prescribers, the tension between enclaving and sharing of knowledge presents an equity issue. Transitioning to a client care-centred model that begins with the needs of the patient, carer or farmer will require sharing unbiased antibiotic information at the point of care.