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1574. Patient, Health System, and Clinical Encounter Characteristics Associated with Use Of Antibiotics Without A Prescription In The United States
BACKGROUND: Use of antibiotics without a prescription (purchased in the United States (U.S.), purchased in other countries, or obtained from friends and relatives) is potentially unsafe and may increase the global risk of antimicrobial resistance. We evaluated the effect of patient, health system, a...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9752383/ http://dx.doi.org/10.1093/ofid/ofac492.103 |
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author | Grigoryan, Larissa Paasche-Orlow, Michael K Alquicira, Osvaldo Barning, Kenneth Mahmood, Hamad Porter, Thomas Khan, Fareed Salinas, Juanita Raphael, Jean Fowler, Michele Street, Richard Trautner, Barbara |
author_facet | Grigoryan, Larissa Paasche-Orlow, Michael K Alquicira, Osvaldo Barning, Kenneth Mahmood, Hamad Porter, Thomas Khan, Fareed Salinas, Juanita Raphael, Jean Fowler, Michele Street, Richard Trautner, Barbara |
author_sort | Grigoryan, Larissa |
collection | PubMed |
description | BACKGROUND: Use of antibiotics without a prescription (purchased in the United States (U.S.), purchased in other countries, or obtained from friends and relatives) is potentially unsafe and may increase the global risk of antimicrobial resistance. We evaluated the effect of patient, health system, and clinical encounter factors on intention to use antibiotics without a prescription. METHODS: Waiting room survey conducted from January 2020 and March 2021 in three continuity and three same-day public primary care clinics and two private emergency departments. Non-prescription use was defined as the consumption of antibiotics not prescribed for the individual’s current condition. Intended use was defined as professed intention to take antibiotics if feeling sick, without contacting a doctor, nurse, or clinic, in any of the following situations: 1) buying antibiotics without a prescription in the U.S., 2) buying antibiotics without a prescription in another country, and 3) getting antibiotics from friends or relatives. The effect of patient, health care system, and clinical encounter factors were studied using multivariate logistic regression. RESULTS: Of the 564 respondents, 247 (43.8%) reported prior use of non-prescription antibiotics; half of these instances involved penicillins (mostly amoxicillin). Overall, 177 (31.4%) of the respondents intended to use antibiotics without a prescription from one of the three sources (Figure 1). Younger age, lack of health insurance and high cost of doctor visits were predictors of intention to buy antibiotics without a prescription in the U.S. (Table 1). Predictors of intention to buy antibiotics without a prescription from other countries included younger age, being interviewed in Spanish, and reporting that a language barrier is a major problem for medical appointments. Lack of health insurance and high cost of physician visits were associated with the intention to use antibiotics obtained from relatives or friends. [Figure: see text] [Figure: see text] CONCLUSION: Interventions aimed at reducing non-prescription antibiotic use should focus on addressing language barriers, ensuring health insurance coverage, and reducing financial barriers to primary care visits. DISCLOSURES: Larissa Grigoryan, MD, PhD, Rebiotix Inc: Grant/Research Support Michael K. Paasche-Orlow, MD, MPH, GlaxoSmithKline: Advisor/Consultant Barbara Trautner, MD, PhD, Genetech: Advisor/Consultant. |
format | Online Article Text |
id | pubmed-9752383 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-97523832022-12-16 1574. Patient, Health System, and Clinical Encounter Characteristics Associated with Use Of Antibiotics Without A Prescription In The United States Grigoryan, Larissa Paasche-Orlow, Michael K Alquicira, Osvaldo Barning, Kenneth Mahmood, Hamad Porter, Thomas Khan, Fareed Salinas, Juanita Raphael, Jean Fowler, Michele Street, Richard Trautner, Barbara Open Forum Infect Dis Abstracts BACKGROUND: Use of antibiotics without a prescription (purchased in the United States (U.S.), purchased in other countries, or obtained from friends and relatives) is potentially unsafe and may increase the global risk of antimicrobial resistance. We evaluated the effect of patient, health system, and clinical encounter factors on intention to use antibiotics without a prescription. METHODS: Waiting room survey conducted from January 2020 and March 2021 in three continuity and three same-day public primary care clinics and two private emergency departments. Non-prescription use was defined as the consumption of antibiotics not prescribed for the individual’s current condition. Intended use was defined as professed intention to take antibiotics if feeling sick, without contacting a doctor, nurse, or clinic, in any of the following situations: 1) buying antibiotics without a prescription in the U.S., 2) buying antibiotics without a prescription in another country, and 3) getting antibiotics from friends or relatives. The effect of patient, health care system, and clinical encounter factors were studied using multivariate logistic regression. RESULTS: Of the 564 respondents, 247 (43.8%) reported prior use of non-prescription antibiotics; half of these instances involved penicillins (mostly amoxicillin). Overall, 177 (31.4%) of the respondents intended to use antibiotics without a prescription from one of the three sources (Figure 1). Younger age, lack of health insurance and high cost of doctor visits were predictors of intention to buy antibiotics without a prescription in the U.S. (Table 1). Predictors of intention to buy antibiotics without a prescription from other countries included younger age, being interviewed in Spanish, and reporting that a language barrier is a major problem for medical appointments. Lack of health insurance and high cost of physician visits were associated with the intention to use antibiotics obtained from relatives or friends. [Figure: see text] [Figure: see text] CONCLUSION: Interventions aimed at reducing non-prescription antibiotic use should focus on addressing language barriers, ensuring health insurance coverage, and reducing financial barriers to primary care visits. DISCLOSURES: Larissa Grigoryan, MD, PhD, Rebiotix Inc: Grant/Research Support Michael K. Paasche-Orlow, MD, MPH, GlaxoSmithKline: Advisor/Consultant Barbara Trautner, MD, PhD, Genetech: Advisor/Consultant. Oxford University Press 2022-12-15 /pmc/articles/PMC9752383/ http://dx.doi.org/10.1093/ofid/ofac492.103 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Abstracts Grigoryan, Larissa Paasche-Orlow, Michael K Alquicira, Osvaldo Barning, Kenneth Mahmood, Hamad Porter, Thomas Khan, Fareed Salinas, Juanita Raphael, Jean Fowler, Michele Street, Richard Trautner, Barbara 1574. Patient, Health System, and Clinical Encounter Characteristics Associated with Use Of Antibiotics Without A Prescription In The United States |
title | 1574. Patient, Health System, and Clinical Encounter Characteristics Associated with Use Of Antibiotics Without A Prescription In The United States |
title_full | 1574. Patient, Health System, and Clinical Encounter Characteristics Associated with Use Of Antibiotics Without A Prescription In The United States |
title_fullStr | 1574. Patient, Health System, and Clinical Encounter Characteristics Associated with Use Of Antibiotics Without A Prescription In The United States |
title_full_unstemmed | 1574. Patient, Health System, and Clinical Encounter Characteristics Associated with Use Of Antibiotics Without A Prescription In The United States |
title_short | 1574. Patient, Health System, and Clinical Encounter Characteristics Associated with Use Of Antibiotics Without A Prescription In The United States |
title_sort | 1574. patient, health system, and clinical encounter characteristics associated with use of antibiotics without a prescription in the united states |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9752383/ http://dx.doi.org/10.1093/ofid/ofac492.103 |
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