The study highlights the need to increase trust in healthcare to limit the use of antibiotics

The study highlights the need to increase trust in healthcare to limit the use of antibiotics

Are many Swedes receiving antibiotics without a prescription, and what drives their behavior when this happens? The answers are important when it comes to dealing with antibiotic resistance, which poses a serious challenge for the entire healthcare sector. Practical philosophers and political scientists from the University of Gothenburg have conducted a large study examining Swedes' experiences with receiving antibiotics without a prescription and their attitudes towards it.

The researchers are affiliated with the Center for Antibiotic Resistance Research (CARe) at the University of Gothenburg, and their study was recently published in the scientific journal PLOS One.

To slow the development of resistant bacteria, it is important to limit the use of antibiotics. For this reason, health services try to limit the prescription of antibiotics and doctors are encouraged to adopt a restrictive approach. At the same time, there are many ways to get antibiotics without a prescription, for example when traveling abroad, through contacts abroad or from online pharmacies that circumvent national regulations.

“First we carried out a smaller pilot study,” says Christian Munthe, who led the study together with Erik Malmqvist and Björn Rönnerstrand. "Eighteen percent of respondents reported receiving antibiotics without a prescription and 16 percent would consider doing so, which is very concerning. Their motivation was often that they were dissatisfied with or did not trust healthcare."

Few research studies

The researchers found only a few publications on the topic, most of which dealt with related phenomena or drugs in general. However, no study had examined the problem specifically for antibiotics or why some people circumvent society's rules designed to control antibiotic use.

“We therefore conducted a large study using the SOM Institute’s Swedish Citizen Panel with several thousand people, representing a more representative sample of the general population, to examine the hypothesis that trust in healthcare plays an important role in this phenomenon.”

Christian Munthe, first author of the study

One of their key findings was that the proportion of Swedes who have received or would like to receive antibiotics without a prescription is lower than suggested in the pilot study. At the same time, almost 5 percent of those surveyed would be willing to do this in the future, almost twice as many as those who said so (2.3 percent). The other main finding is that trust in health care – or lack of trust – outweighed all other potential explanatory factors, such as level of education and concern for one's health.

Need for action

“As we know that trust in healthcare varies greatly from country to country, our results for countries with lower trust rates than the Nordic countries provide a strong reason to review the situation and take action if it turns out that many people have trust to get antibiotics without a prescription.”

The researchers believe that Sweden also has good reasons to keep an eye on this issue, as many people are willing to buy antibiotics without a prescription in the future.

“It is also important to consider the need to maintain and increase trust in health care when developing strategies to limit antibiotic use.”

Source:

University of Gothenburg

Reference:

Munthe, C., et al. (2022) Non-prescription purchase of antibiotics: Prevalence, motives, pathways and explanatory factors in the Swedish population. PLUS ONE. doi.org/10.1371/journal.pone.0273117.

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