Title Propisivanje i uporaba antibiotika za liječenje infekcija gornjeg dišnog sustava u gradu Zagrebu: Stavovi, ponašanja i znanja liječnika i pacijenata
Title (english) Antibiotic prescribing and usage for the upper respiratory sistem infections in the city of Zagreb: Physicians' and patients' attitudes, behaviors and knowledge
Author Monika Šćulac
Mentor Maja Ortner Hadžiabdić (mentor)
Committee member Maja Ortner Hadžiabdić (predsjednik povjerenstva)
Committee member Anita Hafner (član povjerenstva)
Committee member Renata Jurišić Grubešić (član povjerenstva)
Granter University of Zagreb Faculty of Pharmacy and Biochemistry (Centre for applied pharmacy) Zagreb
Defense date and country 2018-06-18, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Pharmacy Pharmacy
Abstract Cilj istraživanja. Cilj ovog rada bio je kvalitativnim metodama istražiti stavove, mišljenja i znanja o uporabi antibiotika za liječenje infekcija gornjih dišnih puteva s ciljem boljeg razumijevanja prakse propisivanja i uporabe antibiotika na području grada Zagreba.
Sudionici i metode. Istraživanje je kvalitativne prirode pa je odabrana metoda prikupljanja podataka bio intervju, odnosno strukturirani, neformalni razgovor o istraživanoj temi. U istraživanje je uključeno ukupno deset sudionika, od čega pet pacijentica kojima je propisan antibiotik koji su koristili u posljednja tri mjeseca te tri liječnice i dva liječnika obiteljske medicine koji su u posljednjih tjedan dana propisali antibiotik za liječenje infekcije gornjeg respiratornog trakta. Ispitanicima je bila osigurana anonimnost i povjerljivost podataka, a rezultati su se analizirali zbirno te nitko osim istraživačkog tima nije imao pristup informacijama dokumentiranim tijekom intervjua.
Rezultati. Liječnici su jednoglasno istaknuli da jasan klinički nalaz prilikom pregleda pacijenta često vodi propisivanju antibiotika bez upućivanja na dodatne dijagnostičke pretrage, a upućivanje na dodatne pretrage ponekad je otežano zbog nedostupnosti određenih dijagnostičkih metoda, njihovih troškova i izostanku volje pacijenata. Pacijenti koji vrše pritisak na liječnika u propisivanju antibiotika najvažniji su činitelj koji doprinosi propisivanju antibiotika kada za njima nema stvarne potrebe. Doprinos smanjenju propisivanja antibiotika bez utemeljene indiciranosti, prema sudionicima istraživanja, ostvariv je unutar sljedećih pretpostavki: poboljšanih uvjeta rada, trajne edukacije pacijenata i određenih obilježja liječničkog ponašanja. Sudionici navode da je problem rezistencije na određene bakterije prisutan i procjenjuju da se on u većoj mjeri odnosi na bolničke uvjete i infekcije. Pacijenti su demonstrirali poznavanje osnovnih znanja o antibioticima. Navedeno znanje se temelji na razlikovanju bakterijske-virusne infekcije, te važnosti cjelovitog i propisnog korištenja ovog lijeka. Dobiveni rezultati istraživanja upućuju na homogeni stav sudionika o važnosti izostanka dostupnosti antibiotika pacijentima bez liječničkog recepta. Propisivanje treba ostati u liječničkoj domeni kako bi se njihova zlouporaba mogla što više smanjiti.
Zaključak. Ova studija identificirala je prilično visok stupanj razumijevanja uporabe antibiotika među pacijentima i racionalnog propisivanja među liječnicima, ali je i ukazala i na dodatnu potrebu za edukacijom i mjerama podizanja svijesti javnosti, ali i svih sudionika zdravstvenog sustava o važnosti antibiotika i njihove pravilne uporabe kao važne ciljeve u kontroli neprimjerene potrošnje antibiotika. Stoga, bi ovakva kvalitativna istraživanja, kojima je cilj istražiti iskustva sudionika in situ, trebalo proširiti na veći broj sudionika i provesti ih na području cijele Hrvatske kako bi se relevantnije identificirala problematika i dinamika razvoja otpornosti bakterija na antibiotike.
Abstract (english) Research aim. The aim of the present study was to examine the attitudes, opinions and knowledge of the use of antibiotics for the treatment of upper respiratory tract infections by means of qualitative methods, with the goal to develop a better understanding of the practice of prescription and use of antibiotics in the area of Zagreb.
Participants and methods. As the research is a qualitative one, an interview, i.e. a structured, informal conversation on the research topic has been chosen as the method of data collection. Altogether 10 participants were included in the study, five of which are patients to whom an antibiotic was prescribed, which they used in the last three months, and three female and two male primary health physicians, who prescribed an antibiotic for the treatment of upper respiratory tract infection in the past week. Participants were guaranteed anonymity and confidentiality of the data, the results were cumulatively analysed and no one apart from the research team had access to the data documented during the interview.
Results. Physicians unanimously pointed out that a clear clinical finding upon the examination of a patient often leads to prescription of antibiotics without referring the patient to additional diagnostic check-ups, and referring to additional check-ups is at times difficult due to unavailability of certain diagnostic methods, their costs or the lack of patient's will. Patients' pressure on the physician to prescribe them antibiotics is the most important factor which contributes to prescription of antibiotics when there are not actually needed. According to research participants, contribution to the decrease of antibiotics prescription without a justified indication is achievable under following assumptions: better working conditions, continuous patient education and certain features of physician behavior. Participants state that a problem of resistance to certain bacteria is present and they estimate that it refers to a greater extent to hospital conditions and infections. The patients demonstrated basic knowledge of antibiotics. The aforementioned knowledge is based on the differentiation of a bacterial and viral infection and the importance of the overall and prescribed use of that medicine. The acquired research results indicate a homogeneous attitude of the participants towards the importance of the lack of antibiotics availability to the patients without a medical receipt. The prescription should remain in the medical domain in order to decrease their abuse as much as possible.
Conclusion. The present study identified a fairly high degree of understanding of the antibiotics use among the patients and a rational prescription among the physicians, but it indicated an additional need for education and measures of raising the public awareness, but also the awareness of all participants in the health care system regarding the importance of antibiotics and their proper use as significant goals in the control of inappropriate antibiotics consumption. Therefore, such qualitative research with the aim of examining the experiences of participants in situ should be extended to a greater number of participants and conducted in entire Croatia in order to identify more relevantly the issue and dynamics of development of bacterial resistance to antibiotics.
Keywords
Republika Hrvatska
kvalitativno istraživanje
infekcije gornjeg dišnog sustava
propisivanje antibiotika
uporaba antibiotika
antibiotska rezistencija
Keywords (english)
Republic of Croatia
qualitative research
upper respiratory tract infections
antibiotics prescription
use of antibiotics
antibiotic resistance
Language croatian
URN:NBN urn:nbn:hr:163:271337
Study programme Title: Pharmacy Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2019-03-06 11:03:44