Perspectives on Non-Prescription Antibiotic Use among Hispanic Patients in the Houston Metroplex

Authors

Lindsey Laytner
Patricia Chen
Susan Nash
Michael K Paasche-Orlow
Richard Street
Roger Zoorob
Barbara Trautner
Larissa Grigoryan

Publication Date

5-8-2023

Journal

Journal of the American Board of Family Medicine

DOI

10.3122/jabfm.2022.220416R1

PMID

37127346

PMCID

PMC10706826

PubMedCentral® Posted Date

12-8-2023

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Adult, Female, Humans, Anti-Bacterial Agents, Communication, Hispanic or Latino, Language, Pharmacists, Access to Health Care, Antibacterial Drug Resistance, Antimicrobial Stewardship, Behavioral Science, Community-based Research, Culturally Sensitive Research, Family Medicine, Health Behavior, Health Care Seeking Strategies of Patients, Health Communication, Health Disparities, Health Literacy, Hispanics, Minority Health, Patient-Oriented Research, Primary Health Care, Public Health, Qualitative Research

Abstract

BACKGROUND: Non-prescription antibiotic use includes taking an antibiotic without medical guidance (e.g., leftovers, from friends/relatives, or purchased without a prescription). Non-prescription use contributes to antimicrobial resistance, adverse drug reactions, interactions, superinfection, and microbiome imbalance. Qualitative studies exploring perspectives regarding non-prescription use among Hispanic patients are lacking. We used the Kilbourne Framework for Advancing Health Disparities Research to identify factors influencing patients' non-prescription use and organize our findings.

METHODS: Our study includes Hispanic primary care clinic patients with different types of health insurance coverage in the Houston metroplex who endorsed non-prescription use in a previous survey. Semistructured interviews explored the factors promoting non-prescription use in Hispanic adults. Interviews were conducted remotely, in English or Spanish, between May 2020 and October 2021. Inductive coding and thematic analysis identified motives for non-prescription use.

RESULTS: Participants (n = 35) were primarily female (68.6%) and aged 27 to 66. Participants reported obtaining antibiotics through trusted persons, sold under-the-counter in US markets, and purchased without a prescription abroad. Factors contributing to non-prescription use included beliefs that the doctor visit was unnecessary, limited access to healthcare (due to insurance constraints, costs, and clinic wait times), and communication difficulties (e.g., language barriers with clinicians and perceived staff rudeness). Participants expressed confidence in medical recommendations from pharmacists and trusted community members.

CONCLUSIONS: Patient, healthcare system, and clinical encounter factors contribute to non-prescription use in Hispanic communities. Antibiotic stewardship interventions that involve pharmacists and trusted persons, improve access to care, and address communication barriers and cultural competency in the clinic may help reduce non-prescription use in these communities.