Grant support for ASP provided by. Become an underwriter». All rights reserved. The University of Minnesota is an equal opportunity educator and employer. Skip to main content. University of Minnesota. Driven to Discover. Site Search Enter your keywords. Staff Mission Contact Us. Chinese study finds no prescription necessary in many pharmacies Filed Under :. Antimicrobial Stewardship. Oct 07, Share this page:. Antibiotic-seeking scenarios For the study, the researchers recruited and trained 48 medical students from Xi'an Jiaotong University to be simulated clients and present one of two antibiotic-seeking scenarios no prescription pharmacy 2, community pharmacies in six Chinese provinces Hunan, Sichuan, Zhejiang, Henan, Shandong, and Shaanxi.
Part of the problem, part of the solution In an accompanying editorial, Aubrey Kalungia, MSc, of the University of Zambia and Brian Godman, PhD, of the University of Strathclyde in Scotland write that the study highlights the significant role that community pharmacies—frequently the first point of contact with the healthcare system—play in inappropriate antibiotic use not only in China but in other low- and middle-income countries LMICs as well.
Sign up now». Related News All news. Introduction Antibiotics are the most commonly prescribed medicines in the world [ 1 ]. Method Study design The simulated client method included investigators trained strictly in accordance with planned procedures to survey the service site as ordinary customers to simulate a real-world experience.
Study variables The record sheet that was modified based on published studies consisted of four parts [ 15 ] S3 Appendix. Statistical analysis It is reported that the no prescription pharmacy of non-prescription sales of antibiotics is higher in rural areas [ 20 ]. Results Characteristics of pharmacies and reception staff Table 1 shows the characteristics of pharmacies and reception staff.
Download: PPT. Table 1. The characteristics of community pharmacies and reception staff. Non-prescription sale of antibiotics The non-prescription sale of antibiotics in Guangzhou is summarized in Table 2. Univariate analysis and multiple logistic regression analysis Table 3 shows that a univariate logistical analysis was used to ascertain the relationship between the non-prescription sale of antibiotics and characteristics of pharmacies and reception staff.
Table 3. The relationship between the non-prescription sale of antibiotics and the characteristics of pharmacies and reception staff in Guangzhou. Service quality First, we compared the service quality of pharmacies between the main districts and the outer international pharmacy, as shown in Table 4.
Fig 1. Medication or prevention advice given by reception staff in community pharmacies in Guangzhou. Fig 2. The types of non-antibiotic medicines recommended by reception staff in community pharmacies in Guangzhou. Table 4. Differences in the service quality of community pharmacies between the main districts and the outer districts in Guangzhou.
Table 5. Differences of in service quality between sole-proprietor pharmacies and chain pharmacies in Guangzhou. Discussion In our study, more than half of community pharmacies in Guangzhou dispensed antibiotics without a prescription. Conclusion Our findings fill a data gap regarding the non-prescription sale of antibiotics in Guangzhou, China.
Supporting information. S1 Appendix. Sample composition. S2 Appendix. Investigation process. S3 Appendix. Recording sheet. S4 Appendix. References 1. Global antibiotic consumption to an analysis of no prescription pharmacy pharmaceutical sales data.
Lancet Infect Dis. Global increase and geographic convergence in antibiotic consumption between and Antibiotic resistance—the need for global solutions. Ministry of Health of the People's Republic of China. Prescription management. Liu J. Tackling the global non-prescription use of antibiotics. National Medical Products Administration. The supervision of antibacterial drug sales in community pharmacies should be strengthened and rational drug use should be promoted.
National action plan for the containment of antibacterial resistance — Prescription and non-prescription antibiotic dispensing practices in part I and part II pharmacies in Moshi municipality, Kilimanjaro region in Tanzania: a simulated clients approach. PLos One. Evaluation of the extent and reasons for increased non-prescription antibiotics use in a University town, Nsukka No prescription pharmacy.
Int J Health Sci. View Article Google Scholar Non-prescription sale and dispensing of antibiotics in community pharmacies in Zambia. Expert Rev Anti Infect Ther. Khan TM, Ibrahim Y. A qualitative exploration of the non-prescription sale of drugs and incidence of no prescription pharmacy events in community pharmacy settings in the Eastern province of the kingdom of Saudi Arabia. Bhanwra S. A study of non-prescription usage of antibiotics in the upper respiratory tract infections in the urban population.
J Pharmacol Pharmacother. Non-prescription antibiotic use in Hungary. Pharm World Sci. Global access to antibiotics without prescription in community pharmacies: a systematic review and meta-analysis. J Infect. Assessment of non-prescription antibiotic dispensing at community pharmacies in China with simulated clients: a mixed cross-sectional and longitudinal study. National Bureau of Statistics. China Statistical Yearbook.
Study on the employment of licensed pharmacists in retail pharmacies in Qinghai, Yunnan, Sichuan and Guangdong Provinces. China Pharm. Wu H-X. Investigation of the development situation of Guangzhou drug retail market.
Morawska L, Cao J. Environ Int. Magnitude and determinants of antibiotic dispensing without prescription in Spain: a simulated patient study. J Antimicrob Chemother. Missing data: our view of the state of the art. Psychol Methods. Zhongyan L. The research on regional comprehensive economic strength of Guangzhou.
Master, Jinan University. Self-medication and self-prescription with antibiotics in the Middle East-do they really happen? A systematic review of the prevalence, possible reasons, and outcomes. Int J Infect Dis. Guangzhou Statistics Bureau. Population size and distriution of Guangzhou in Parental knowledge and awareness linked to antibiotic use and resistance: comparison of urban and rural population in Croatia. Microb Drug Resist.
Miller R, Goodman C. Do chain pharmacies perform better than independent pharmacies? Evidence from a standardised patient study of the management of childhood diarrhoea and suspected tuberculosis no prescription pharmacy urban India.
BMJ Glob Health. Variation in antibiotic use in the European Union. Antibiotics for respiratory, ear and urinary tract disorders and consistency among GPS. Trends in antimicrobial drug prescribing among office-based physicians in the United States.
Allergic reactions to antibiotics, mainly betalactams: facts and controversies. Eur Ann Allergy Clin Immunol. Andrographis paniculata Chuan Xin Lian for symptomatic relief of acute respiratory tract infections in adults and children: a systematic review and meta-analysis.
Traditional chinese medicine for diabetic retinopathy: a systematic review and meta-analysis. Efficacy and safety of oral traditional Chinese patent medicine in treatment of liver stagnation and spleen deficiency of depression: a protocol for systematic review.
Implementing green supply chain management for online pharmacies through a VADD inventory model. Globe Newswire. European citizens' use of E-health services: a study of seven countries.
BMC Public Health. Lombardo S, Cosentino M. Internet use for searching information on medicines and disease: a community pharmacy-based survey among adult pharmacy customers.
Interact J Med Res. Meng L, Wu Z. Exploration on establishment of unified electronic trading platform of online pharmacies in Https://health21viagra.com/2-walmart-pharmacy-price-check-pacu.php. Health outcomes in patients using no-prescription online pharmacies to purchase prescription drugs. J Med Internet Res. The problems and measures of supervision of standardized management of the online pharmacies in China.
Chin Pharm J. Analysing policy interventions to prohibit over-the-counter antibiotic sales in four Latin American countries. Trop Med Int Health. Assessing the impact of law enforcement to reduce over-the-counter OTC sales of antibiotics in low- and middle-income countries; a systematic literature review.
Chinese study finds no prescription necessary in many pharmacies | CIDRAP
Household antimicrobial self-medication: a systematic review and meta-analysis of the burden, risk factors and outcomes in developing no prescription pharmacy. Non-prescription use of antibiotics among children in urban China: a cross-sectional survey of knowledge, attitudes, and practices.
At least 33 states have enacted Prescription Drug Monitoring Programs, and many others are considering them [ 11 ]. These programs have not been extended to all Internet pharmacies, especially those that are based outside of the US.
Under many of the recent laws, patients must be physically examined by a licensed health care practitioner the first time drugs are prescribed to determine if the drug is appropriate for treatment [ 10 ]. When the patient is using an Internet pharmacy, the health care provider is often not involved and cannot perform a physical examination.
Therefore, the patient is self-diagnosing. This process also allows a consumer to misrepresent their medical information. Self-diagnosing, information misrepresentation, and lack of involvement of providers have implications for the medical system and doctor-patient relationship. The added burdens are inappropriate self-treatment, use of counterfeit or inaccurately labeled drugs, and adverse interactions with other medications, all of which may delay or complicate proper treatment.
Doctor-patient relationship may suffer when patients request inappropriate treatments and misinterpret denials as cost cutting [ 19 ]. Under the federal Food, Drug and Cosmetic Act, the FDA has the legal authority to take action against the importation, sale, or distribution no prescription pharmacy adulterated or misbranded drugs; the importation, sale, or distribution of approved new drugs; illegal promotion of a drug; the sale or dispensing of a prescription drug without a valid prescription; and counterfeit drugs [ 1017 ].
When the Internet is used for an illegal sale, the FDA, working with the Department of Justice, must establish the same elements of a case, develop the same charges, and take the same actions as it would if another medium, such as a storefront or a clinic, had been used. The FDA has investigated and referred cases for criminal prosecution and initiated civil enforcement actions against online drug sellers [ 10 ].
In Julythe FDA adopted and implemented the Internet Drug Sales Action Plan to expand and improve the activities of the agency in addressing unlawful sales of drugs over the Internet no prescription pharmacy 10 ]. The plan includes engaging the public by informing them about safe ways to purchase pharmaceutical products over the Internet; verifying the legitimacy of Internet sites dispensing pharmaceuticals; cooperating internationally with foreign governments; and customizing and expanding enforcement activity by establishing priorities, improving data acquisition, and coordinating case assessment [ 17 ].
Still, Palumbo et al [ 14 ] have stated that Congress needs to be more involved in curbing illegitimate online pharmacies. At this time, the US government has limited control over foreign Internet pharmacies. The FDA efforts include requesting other foreign governments to take action against the seller of the product, asking US Customs and Border Protection to stop the imported drug at a US port of entry [ 10 ], or sending warning letters to online sellers [ 21 ].
International cooperation is underway no prescription pharmacy combat online sales of illegal and counterfeit medicines. It lasted one day and involved 8 countries [ 23 ]. Global press coverage of both operations was used to raise consumer awareness about counterfeit medicines.
No Prescription Needed?
No prescription pharmacy it is useful to take down established websites by illegal pharmacies, the online sellers often employ direct-to-consumer advertisement strategies, such as no prescription pharmacy spam messages with Web links to ephemeral websites.
These websites are hard to track due to their transient nature. Gernburd and Jadad studied health spam offers and found that about half of online sellers of health products deactivated their spam links within a week of message delivery and three-quarters deactivated them after one month [ no prescription pharmacy ].
Given pharmzcy global nature of the Internet and the challenge of regulating activities that cross national borders, federal efforts may be insufficient to protect US residents who purchase drugs online. Consumer education is likely to play an important role. This study was designed to gain understanding of how individuals evaluate the websites of two Internet pharmacies that were specifically designed to show many of the unsafe signs and no signs of trustworthiness, as specified by the FDA consumer education materials.
A health version of RRSA, an online interactive application, was designed to help information seekers to become effective, article source users of no prescription pharmacy pharmact from digital electronic sources [ 28 ]. The assessment was used to obtain objective measures of competencies related to finding and evaluating health information.
The evaluation module of the assessment included several questions about online pharmacies. Specifically, the assessment prescgiption were asked pharmaacy review two pharmacy websites, designed specifically for the purposes of the assessment. The features of these websites were common to websites of illegitimate online pharmacies. Responses by about individuals who completed the assessment between September and March were used to examine the degree to which college-educated information seekers are able to determine the trustworthiness of online pharmacies.
The no prescription pharmacy of this study can provide important insights for policy makers, authorities involved in pharmacies online pharmacy operations, and consumer educators.
Since Septembera prescriltion online assessment titled Research Readiness Self-Assessment, Health Version RRSA-Health was administered to students, most of whom were enrolled in introductory health courses at a large Midwestern university. The study was approved by an institutional review board IRB. The interactive online assessment contained questions about Prescriotion pharmacies specifically designed for this study that showed multiple signs of low credibility.
The findings of this study can be generalized to a population of healthy young adults who are in their early 20s and enrolled in college programs. These individuals have the requisite computer skills related to using email, navigating no prescription pharmacy, and conducting pharmmacy searchers in popular search engines. Individuals in this age group are among the most active prescripfion of the Internet, who are likely to do information searchers for themselves and others, for example, less computer literate family members.
The RRSA is an online assessment of eHealth literacy skills, specifically, those related to finding and evaluating health information from digital sources. It is a combination of an e-survey and an e-test with detailed performance feedback and suggested resources for skill improvement. To complete the RRSA, participants needed basic computer skills that are now acquired at the high school level. The purpose, development, rpescription administration pjarmacy the RRSA were described in an earlier study by Ivanitskaya et al [ 28 ].
To assess how students would evaluate these online pharmacies, six new items were developed, as well as seven additional items that asked students to explain pharmayc drug costs. The addition of new questions lengthened the average completion time from 26 to 37 minutes. The link to an assessment was given via an email and posted on a course website. In addition, instructors who taught face-to-face courses advertised the RRSA in class.
A password was required to register for and then to participate in the assessment. The presrciption were informed that their participation was voluntary, that the assessment takes about 35 minutes to complete, and that pharmay aggregate data may be used for research purposes.
Access to online respondent data was restricted through a password, an identification of a unique IP address, and a minute time limit. The two pharmacies featured in the assessment had a large number of untrustworthy features see Table 1 prescrription no signs of trustworthiness listed in the recent FDA update [ 18 ]. Students accessed the two websites by clicking on links provided in the RRSA presfription.
The pharmacy websites were kept on a local server. Researchers who recently studied characteristics of Internet pharmacies reported nk 96 of drug sellers did not require a medical prescription [ 29 ].
The two websites were designed to show that the pharmacies were located outside of the US. Just like the original pjarmacy, these pharmacies could be contacted by FAX, via email, or by submitting a comment typed into an online textbox. No phone numbers were given to contact a live person. Also of concern pharmady the large amount of personal information requested from customers. Similar to the original websites on which the two pharmacies were modeled, the online text contained grammatical mistakes and typographical errors.
The two pharmacy prescriptuon used in this study were designed to display below average surface credibility. Therefore, no prescription pharmacy is unlikely that many study participants were impressed by the design or appearance of the websites. While searching for cheaper options, you found two online pharmacies. Suppose you have pjarmacy credit card and do not mind using it online.
Other measured variables were demographics gender and age and pharmaccy health major, yes or no, and the number of college credits earned to date. Finally, there was a measure of health-related Internet behavior, that is, whether an individual had used information from general Internet searches for health decision making for themselves or to help others.
The participants were drawn from the population of undergraduate and graduate students enrolled in health-related courses offered by a Midwestern university.
In Figure 1each of the respondents is designated as a dot, the placement of which is based on how this respondent rated Pharmacy A and Pharmacy B. There was a lot of variation in how the respondents rated pharmacies. The top left triangle has more dots than the bottom right triangle, which means that Pharmacy A was evaluated more favorably than No prescription pharmacy B.
Indeed, the median rating for Pharmacy A was 4. In Figure 1red lines divide the scatter plot into nine quadrants based on bottom one-third, middle one-third, and top one-third of the ratings out of 10 of each pharmacy. Percent of respondents in each cell is presented ho Table 2. About half of the participants Table 5 shows reasons commonly chosen by the study participants to explain why No prescription pharmacy B sells Beozine much cheaper than a local neighborhood pharmacy.
Both pharmacies offered drugs at a lower price than a neighborhood pharmacy. To keep the assessment completion time under 40 minutes, participants were asked to explain a cheaper price at only prfscription pharmacy, which displayed a greater number of features that put into question its legitimacy. Other commonly chosen reasons were potentially lower quality of drugs, supplementary revenues from advertising, customer pressures comparison shopping prescripfion, higher sales volume, and supplementary revenues from selling information about no prescription pharmacy.
To better understand phsrmacy responses, reasons for low drug cost were sorted into three categories: 1 negative reasons that have the potential to cause harm to pharmacy customers, 2 neutral reasons, and 3 none of the above. The number of neutral reasons checked also had a significant relationship with pharmacy ratings but in the opposite direction.
Next, as a proxy measure of critical prescgiption, a pharmacy evaluation index was calculated as a mean of five factor prescritpion 1 ability to recognize negative reasons for low prsscription of Beozine at Pharmacy B; 2 willingness to recommend Pharmacy A to friends and family; 3 willingness to recommend Pharmacy B to pharmac and family; 4 rating of Pharmacy A as a place to purchase Beozine; and 5 rating of Pharmacy B as a place to purchase Beozine.
Scaled 0 to 1 with a rating of one representing better judgment, factors no prescription pharmacy and 5 were prepared for inclusion in no prescription pharmacy pharmacy evaluation index. Independent-samples t tests were conducted to evaluate if individuals who use Internet information for making health decisions demonstrate better critical judgment skills, as indicated by the pharmacy evaluation index. The results were counter to expectations.
Predictors of the pharmacy evaluation index were examined using a hierarchical regression analysis. As can be seen in Table 6Model 1 took into account demographics, education, and self-reported health. All of these variables, except self-reported health, were significantly and positively related to the pharmacy evaluation index.
Gender was not a significant predictor of pharmacy judgment.
Health outcomes in patients using no-prescription online pharmacies to purchase prescription drugs
Model 2 included the no prescription pharmacy predictors as Model 1 plus Internet-related beliefs and behaviors. After controlling prsecription Model 1 predictors, whether an individual used information from general Internet searches for health decision making for self or to help others was a significant negative predictor, as well as a belief in the high quality of Internet health information.
The practical significance of this finding is limited by a prescrption effect size. The findings of this study indicate that university students are not making appropriate judgments about health information that is provided on the Internet. The two Internet pharmacies used in this study had multiple untrustworthy features that were borrowed from five actual pharmacy websites that the authors considered to be potentially dangerous to consumers.
Yet, almost one-half of the study population rated the Pharmacy A site favorably, while over one-third rated Pharmacy B in a favorable manner.
POMs with exemptions for supply without prescription. Find out which Prescription Only Medicines (POM) have exemptions for supply without prescription. “No training is required for the pharmacy worker job. On job we learn how to read prescriptions and about medicines from our seniors.