Espirales. Revista multidisciplinaria de investigación científica, Vol. 7, No. 46
July - September 2023. e-ISSN 2550-6862. pp 65-82
DOI https://doi.org/10.31876/er.v6i44.836
Qualitative study on antibiotic management in households:
perception of family caregivers
Estudio cualitativo sobre la gestión de los antibióticos en los hogares:
percepción de cuidadores familiares
Marco Esteban Morales Rojas*
Amairani Lucelly Ceh Alvarado**
Didier Francisco Aké Canul***
Sheila Mariela Cohuo Cob****
Maricela Balam Gómez*****
Received: Febrary 11, 2023
Approved: May 26, 2023
* Maestro en Salud Pública (MSP). Marco Esteban Morales Rojas.
Profesor de educación superior. Facultad de Enfermería de la
Universidad Autónoma de Yucatán. C. 90 s/n x 59 y 59ª Contiguo al
Hospital O ‘Horán Código Postal 97000.
marco.morales@correo.uady.mx. ORCID: https://orcid.org/0000-
0003-3416-0806. Mérida, Yucatán, México. CORRESPONSAL.
* Licenciada en Trabajo Social (LTS). Amairani Lucelly Ceh Alvarado.
Profesor de educación superior. Facultad de Enfermería de la
Universidad Autónoma de Yucatán. amairani.ceh@correo.uady.mx.
ORCID: https://orcid.org/0000-0002-4340-5724. Mérida, Yucatán,
México.
* Doctor en Salud Publica. (Dr. en SP). Didier Francisco Aké Canul.
Profesor de educación superior Facultad de Enfermería de la
Universidad Autónoma de Yucatán. didier.ake@correo.uady.mx.
ORCID: https://orcid.org/0000-0001-8089-9156.
* Doctora en Salud Publica. (Dra. en SP). Sheila Mariela Cohuo Cob.
Profesor de educación superior. Facultad de Enfermería de la
Universidad Autónoma de Yucatán. sheila.cohuo@correo.uady.mx.
ORCID: https://orcid.org/0000-0003-4936-5142. Mérida, Yucatán,
México.
* Doctora en Salud Publica. (Dra. en SP). Maricela Balam Gómez.
Profesor de educación superior. Facultad de Enfermería de la
Universidad Autónoma de Yucatán.
maricela.balam@correo.uady.mx. ORCID: https://orcid.org/0000-
0002-0546-7887- Mérida, Yucatán, México.
Abstract
The available literature shows quantitative studies on the
management of antibiotics; however, few investigations describe the
perceptions and experiences of family caregivers with a qualitative
approach. To explore the perceptions of family caregivers who
manage antibiotic medications at home. Qualitative, descriptive
scope and cross section. The information was collected through semi-
structured interviews with caregivers with relatives who have a chronic
degenerative disease, and without studies related to health care.
Antibiotics have limitations at the time of access, which influences the
storage that families have in their homes, the storage characteristics
lie on the site and not in the container. Caretakers do not check
expiration dates; medicines are discarded without established
measures. The perceptions of caregivers in rural contexts differ from
those in the urban context. Caregivers participate in the medication
management process and recognize that they can improve their
practices, therefore, the perceptions of access, storage, use, and
disposal are necessary for improvement proposals.
Keywords:
Home caregivers, Antibiotics, Qualitative approach.
Cite this:
Morales, M., Ceh, A. Aké, D.,
Cohuo, S., Balam, M. (2023).
Qualitative study on antibiotic
management in households:
perception of family caregivers.
Espirales Revista Multidisciplinaria
de investigación científica, 7 (46),
65-82
Qualitative study on antibiotic management in households: perception of family caregivers
Espirales. Revista multidisciplinaria de investigación científica, Vol. 7, No. 46
July - September 2023. e-ISSN 2550-6862. pp 65-82
66
Introduction
Medicines or drugs are one of the fundamental tools in current therapy, along with the
execution of an adequate medical diagnosis they allow the cure of diseases, attenuation
of signs and symptoms derived from diseases, as well as the prevention of complications
from acute or chronic and degenerative diseases (Vera, 2020).
Within the functional groups of drugs, antibiotics are substances that, through different
mechanisms, can cause death (bactericidal) or reduction of reproduction (bacteriostatic)
during a bacterial infection (González et al., 2021).
These medicines have great health value for their contribution to disease control and
for improving the life quality; Also, they have a superlative value for families, because
they represent a good with a high economic cost, as well as a short-term response to
health problems The social relationship between people and medicines is the object of
study of the social pharmacology, declared as the discipline in charge of analyzing the
impact on social and cultural factors have on access, use, storage, final disposal, and
effects of medications, including antibiotics. (González et al., 2021).
Thus, drug management covers all procedures related to it, and includes the selection
based on its certified quality, safe use by the patient, as well as its regulated disposal
to protect the environment (Rodríguez and Roig, 2020).
Resumen
La
gestión de antibióticos en los hogares abarca el acceso,
almacenamiento, utilización y desecho, siendo los cuidadores los
principales responsables de estas actividades. La literatura disponible
muestra estudios cuantitativos sobre la gestión de antibióticos, sin
embargo, pocas investigaciones describe las percepciones y
vivencias de cuidadores familiares con un abordaje cualitativo.
Explorar las percepciones de cuidadores familiares que gestionan
medicamentos antibióticos en sus hogares. Cualitativo, de alcance
descriptivo y corte transversal. La información fue recolectada
mediante entrevistas semiestructuradas a cuidadores con familiares
que tengan alguna enfermedad crónica degenerativa, y sin estudios
relacionados con la atención sanitaria. Los antibióticos tienen
limitantes al momento del acceso, lo cual influye con el
almacenamiento que tienen las familias en sus hogares, las
características del almacenamiento radican en el sitio y no en el
contenedor. Los cuidadores no revisan las fecha de caducidad; los
medicamentos son desechados sin medidas establecidas. Las
percepciones de los cuidadores de contextos rurales difieren de los
del contexto urbano. Los cuidadores participan en el proceso de
gestión de medicamentos y reconocen que pueden mejorar sus
prácticas, por lo cual, las percepciones del acceso, almacenamiento,
uso y desecho son necesarias para propuestas de mejora.
Palabras clave:
Cuidador de familia, Antibióticos, Análisis Cualitativo.
Marco Esteban Morales Rojas, Amairani Lucelly Ceh Alvarado, Didier Francisco Aké Canul, Sheila Mariela Cohuo Cob,
Maricela Balam Gómez5
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67
Despite the benefits of drugs on the quality of life, it is reported that there is a
phenomenon of inappropriate consumption, derived from the excessive and irrational
use of these drugs: The Antimicrobial Resistance (AMR), defined as the ability of a
bacterial microorganism to resist the effects of antibiotics; through an inherent
characteristic of the bacterium or a capacity acquired during the infectious process
(Cerezo et al., 2020).
According to the United Nations Organization (UN), this phenomenon is considered
one of the main global threats, since it endangers priorities such as human
development, economic activities, the food sector, tourism, and migratory flows; which
is why this is one of the main universal problems along with climate change (González
et al., 2019).
AMR harms people's lives since it produces: the failure of common treatments;
increased morbidity and mortality, as well high costs of care by the public system or
out-of-pocket costs for the patient; also it can cause delay in establishing adequate
treatments; increased use of broad-spectrum antimicrobial drugs; additionally, this can
contribute to the failure of medical procedures that depend on the effectiveness of
antibiotics (for example, chemotherapy, transplants, kidney dialysis, etc.) among others
(Lazovski et al., 2018).
Although the understanding of the magnitude and severity of AMR is widely studied in
hospitals, mainly through bacteriological identification studies or focused on the
therapeutic of diseases, the lack of resources and heterogeneity in the populations
make it difficult for study the behaviors that can lead to this phenomenon (Vargas et al.,
2018), especially when the aim of the studies is the how or why of the habits of
management at home can cause AMR. (Cerezo et al., 2020).
It's vital to understand the following: most people outside the clinical/pharmaceutical
field tend not to get involved in the responsibility that comes with having drugs at home
or to deal with the harmful consequences or actions that these can trigger. This lack of
skills or abilities tends to be enhanced when the people living in the home suffer from
multiple illnesses (especially chronic, mental related, or degenerative) since it leads to
the phenomenon of polypharmacy, meaning, the use of multiple medications, generally
more than five drugs a day (Sánchez et al., 2022).
Several studies describes that home caregivers, who are family members, have an
important role during the treatment of chronic and degenerative diseases because they
participate in activities related to the management, order, monitoring and taking of
medications, in addition, they carry out actions in the way of accessing medicines,
treatment follow-up, and also ingestion it at the established times and doses, and on
some occasions, they are the ones who administered (Noureldin and Plake, 2017, cited
in Carreño-Moreno et al., 2022).
Qualitative study on antibiotic management in households: perception of family caregivers
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Furthermore, family caregivers assume the responsibility of meeting care needs,
contributing to the adaptive processes of the disease, obtaining, and controlling
medications (González and Crespo, 2020; Laguado-Jaimes, 2020). Various treats can
affect the responsibility, capacities, and abilities of these caregivers in the management
of antibiotics. For example, González and Crespo (2020) mention that most of the home
caregivers do not have training on the care at home that the sick person should receive,
although, they are usually characterized by a high degree of commitment to tasks, which
is determined by the affective relationships between caregiver and patient, in this case,
family members.
Other characteristics are the minimum and necessary skills of home caregivers to
manage medications, which is based on meeting the basics to meet the needs of the
patient and the treatment, such as: understanding the prescription, reading the
indications on the drug, and being aware of the expiration date, to execute their roles
effectively and safely.
Finally, it is crucial to point out that in order to design and develop effective
interventions that involve family caregivers, those who participate in the medication and
antibiotic management process, is required to include the perceptions of the practices
they perform, and based on the findings perform action strategies, support programs
and preventive education sessions for caregivers can be generated that could allow:
reinforcing knowledge about the disease and thus improving the lifestyle of patients to
support them, while reducing the impact and the wear and tear generated by being the
primary caregiver of people living with one or more diseases (González and Crespo,
2020).
For all of the above, the objective of this study is to explore the perceptions of family
caregivers who manage antibiotic medications in their homes.
Materials and methods
The present study is of a qualitative approach, observational design, and descriptive
scope, carried out during the months of august to October of 2022 in an urban area of
the municipality of Yucatán.
On the participants selection, the snowball technique and sampling by criteria was used,
these last ones included: people who handle medications in their homes and lives with
a relative with metabolic diseases, immunological diseases, or some type of cancer,
people who handle medications in their homes and live with children, the elderly, or a
family member with mental health conditions. For this study, people with training in
health sciences or who live with a family member with that profile, as well as minors who
handle the medication at homes or outside the study area, were excluded. The number
of participants was defined based on the principle of theoretical saturation.
For the recollection of information, semi-structured interviews were carried out
supported by a question guide built based on the work of West and others (2020), Pham
Duc and Sriparamananthan (2021), and David and others (2022). The guide was
Marco Esteban Morales Rojas, Amairani Lucelly Ceh Alvarado, Didier Francisco Aké Canul, Sheila Mariela Cohuo Cob,
Maricela Balam Gómez5
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validated by experts in the field of social pharmacology, also experts on the
development of instruments, and researchers, who made recommendations on the
wording and language to facilitate its understanding. The categories on the question
guide can be seen in Table 1. All the interviews were collected through voice recorders
by a researcher and an observer at the participants' homes. Also, non-participant
observation was used to verify the drug storage sites, these impressions were collected
through field diaries.
For the analysis of the information, the proposal by Taylor and Bogdán was used, which
includes three phases: rediscovery, codification, and revitalization of the data. Among
the criteria of rigor to ensure the reliability of the testimonies, credibility in the
construction of the question guide, audibility through recordings, transcripts, and
observers, and finally, the transferability of the information was taken into account
(Cueto, 2020).
Finally, this research has the approval of the Ethics and Research Committee of the
Faculty of Nursing of the Autonomous University of Yucatan. Also, the bioethical and
research criteria established in the Declaration of Helsinki and the General Health Law
on research for health in human beings of the United Mexican States, in article 100, fifth
title, were met respected (Chamber of Deputies of the H. Congress of the Union, 2022).
Table 1.
Categories and subcategories explored in the interview guide.
Category
Subcategories
No. of
Questions
Access to antibiotics
• Antibiotic prescription
• Informal access
• The role of the physician
• The role of the pharmaceutical
industry
3
Antibiotic Home storage
• Container or first-aid kit
• Storage house places
• Household characteristics that
could deteriorate the antibiotics
4
Antibiotic manager
features (Family Caregiver)
• Minimum knowledge or skills to
have.
• Social and demographic
characteristics that could affect the
antibiotic management.
3
Expiration and final
disposal
• Expiry dates management
• Reasons for storing expired
antibiotics.
7
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• Comparison between rural and
urban areas
• How to Improve behaviors
Source: Research team.
Results
Sociodemographic data
The interviews were conducted with a total of 13 people, ranging in age from 20 to 80
years, with an average age of 38.3 years. Regarding sex, 3 men and 10 women who live
with older adults, people with chronic or metabolic diseases (Type 2 Diabetes, Systemic
Arterial Hypertension, cancer, dyslipidemias, and some mental health diseases)
participated, in terms of occupation, the majority were unpaid domestic workers,
employees in companies not related to health and pensioners.
Regarding the characteristics of the context zone, the study site is in an urban area, in
the state capital, and has access to public and private sector pharmacies, and informants
distributed in the south and east of the city who have a medium-low and medium high
socioeconomic level. The declared categories are described below.
Access to antibiotics
The antibiotic management process begins with access, which, according to the
recollection, describes the drugs in general are easily accessible to the population,
without there being any regulation involved, with the current purchase available in local
stores, pharmacies, markets and even being able to share them among the same family.
However, a distinction is identified between access to antibiotics, the latter being more
regulated and exclusively sold with a prescription, after a consultation.
“…There are pharmacies that sell you the medicine without a prescription and it is easier
to obtain them. The same is true in certain markets [tianguis] the medicines are already
being sold…”
E11. Women. 25 years
“…[Antibiotics] have more control because not everyone sells it to you, that is, if you
don't have your prescription, you have to go consult, they have to give you your
prescription and you take it so they can sell you the antibiotic. Yes, some antibiotics
may indeed be left over, and you keep it, but you cannot go buy others when you run
out, you must consult again…”
E5. Woman.45 years
Also, different people and activities are perceived that facilitate these processes:
doctors, when making a prescription for treatment and dosage of medicines that have
surpluses; the pharmaceutical industry, due to the number of products for sale, by
bringing a excess of elements (tablets, capsules, milliliters, etc.) in its commercial
Marco Esteban Morales Rojas, Amairani Lucelly Ceh Alvarado, Didier Francisco Aké Canul, Sheila Mariela Cohuo Cob,
Maricela Balam Gómez5
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presentation in relation to the amount that must be consumed according to the
treatment, the excessive sale through of promotions, as well as the recommendation of
which to buy, with the exception of antibiotics that are recognized as requiring a
prescription.
“…For example, if they give you a 20-day treatment, but the box of tablets contains 15;
you have to buy 2 boxes, and you would already have 30. You have 10 tablets left over;
those are the ones you save for later. Sometimes it is not used, but you have them just
in case because you really don't know when you are going to need it..."
E4. Women. 39 years
In continuity with the management process, there is a relationship between access and
storage of antibiotics, because when requiring a medical prescription for their purchase,
it is decided to protect the surpluses or leftovers, due to the suspension of the treatment
due to presenting an improvement. o Reduction of symptoms or the number of doses
they bring, since the population intends that in this way they have an immediate reach,
to save time and money in the event of having a condition with similar symptoms in the
future.
“…We usually store medicines and antibiotics because the boxes often contain more
pills than we need and, in our longing, to save for future emergencies, we simply keep
them, and they remain …”
E9. Women. 35 years
Home Storage
In the storage of medicines, there are varieties concerning the container, in this study
mainly cardboard/wooden boxes and plastic bags were identified. The perception of
the informants about the features must be met for antibiotics to be safe focuses on the
physical location of the home where they are stored, rather than on the container itself,
and they must have the following characteristics: be a clean place, without humidity or
exposure to the sun or heat, as well be placed in a reachable place of protection, out
of the reach of infants. These perceptions are supported by the following testimonies:
“…Medications must be picked up [save them] and keep them in a safe place so that
the children do not get them, so that the sun does not hit them and they do not get
wet. It doesn't matter if it's a cardboard box, plastic, or a bag..."
E7. Women. 29 years
"...If the place is very humid, even if you put a special container for some pills, it will get
wet, they will swell and decay, it depends on the place, not the container..."
E8. Man. 38 years
Manager aspects
Qualitative study on antibiotic management in households: perception of family caregivers
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Regarding the person managing antibiotics, it is expected that they are in the adult age,
that they know how to read and have empirical knowledge about the use and
classification of these, and for which common symptoms and diseases in the family the
antibiotics are effective.
Likewise, the sociodemographic profile of the person managing medicines and
antibiotics is women in adulthood, since a greater responsibility is perceived in this sex
when performing the role of caregivers, unpaid domestic workers, closeness and
affection with the family, roles that are delegated from previous generations.
“…I think housewives and mothers are the ones who handle medications the best, men
can also handle medications, but the truth is, I think it is more common for women to
do so. For example, in my family I manage it, my sister manages it in her family, in my
brother's house it is managed by her wife, in the house where I grew up my mother
handled the medicines, she oversaw them…”
E4. Women. 39 years.
Expiration dates and disposal.
About the care around the expiration of medications, the informants perceive that it is
common for it to happen in homes, due to the lack of time, consumption, and
information regarding care in the use and disposal of these, since they are only checked
before taking them and not during the storage time.
On the other hand, the reason for the disposal of medicines was perceived by the
informants as a common practice when they expire, due to the lack of effectiveness that
it may have or even the danger of their consumption. Waste actions are divided
according to the type of substance or state of the drug, that is, liquid or solid (tablets,
pills, or capsules); the first ones are emptied on the ground, in the toilet, or in the
household sink and only the container is deposited in the trash, while the second type
is disposed of in the common trash with the box, the blister and the medicine as a whole
since it is perceived that otherwise, it could cause contamination to the environment.
“…Sometimes, due to work or school reasons, we do not follow up [on expiration dates],
but I think that we all really store expired medicines, some even medicines that have
already expired for a long time…”
E10. Women. 21 years
“…I throw the medicines in the trash. For example, if it is syrup; First I throw the
medicine in my patio or in the sink, and then I throw the little bottle in the trash..."
E5. Woman.45 years
Rural and urban contexts
In the first place, it is understood that the management of antibiotics presents
differences according to the context in which patients and caregivers operate, thus,
divergences are perceived in the different stages, such as access, since the Urban cities
Marco Esteban Morales Rojas, Amairani Lucelly Ceh Alvarado, Didier Francisco Aké Canul, Sheila Mariela Cohuo Cob,
Maricela Balam Gómez5
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areas have an easier time buying them, due to the proximity and availability of medical
establishments and pharmacies; secondly, in storage, rural areas have aggravating
climatic conditions in this process, regarding humidity and heat, in addition to
deficiencies in basic housing services that can cause medicines not to be correctly
stored. Finally, in the use and disposal, in rural areas, there is less dissemination of
reliable information about how to take the proper doses, check expiration dates, and
proper disposal.
“…I think that marginalized communities are at risk of worse storage due to different
factors such as how easy it is to obtain a container to store them in, the conditions in
which they live because I know that many communities do not have access to electricity,
air conditioning or a fan, so I feel that they are more exposed…”
E10. Women. 21 years
Improvements in the management of drugs and antibiotics.
The people interviewed make it possible to identify the forms of access, storage, use,
and disposal of medicines and antibiotics, in conjunction with each of the
responsibilities of the actors involved in the process, however, it is perceived that, in the
disposal phase, most failures occur, because there is no guidance, information or follow-
up on them.
Based on the testimonies of the informants, the need to generate and disseminate
simple and clear information regarding the constant review of the expiration date of the
drugs, accompanied by precise instructions on how to dispose of them, is identified as
an opportunity for improvement.
“…Well, I think that for improvement, information must be given, that is, that they know
that she must check the expiration date and discard those that are not good. I really do
not know…"
E5. Woman.45 years
The use of antibiotics in the therapy of diseases is one of the most important discoveries
in medicine and the world since it saves the lives of millions of people. That is why
antimicrobial resistance is fast becoming one of the most serious global problems we
face today. Therefore, the habits of prevention of this phenomenon around the use of
medicines and antibiotics from their access to their disposal or final storage becomes
vitally important to prolong the useful life of antibiotics and reduce the effects of
diseases on the family's well-being (Sulis and Gandra, 2021).
Access to antibiotics derives from family access to health services. In economic terms,
this means a lack of accessibility or affordability to these drugs, while in health terms it
implies the absence of economic, cultural, and geographical barriers for the use of these
drugs. In this research, the participants identify that antibiotics present barriers when
obtaining these drugs from pharmacies, this coincides with what was reported by Hsia
and others in 2019, who established that low- and middle-income countries have
Qualitative study on antibiotic management in households: perception of family caregivers
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difficulties accessing antimicrobials, due to a low supply of medicines, especially in rural
areas and with high poverty rates, coupled with the fact that private pharmacies regulate
access with medical prescriptions as well as their prices (Hsia et al., 2019 ).
These behaviors can lead to informal access when purchasing, as stated by Auta, Hadi,
and Oga, who in a systematic review with meta-analysis establish that in low- and
middle-income countries, up to 62% of antibiotics could be without a prescription (Auta
et al., 2019).
The storage of antibiotics is a key component in the entire phenomenon of antibiotic
management in homes since the participants identify that storage is directly related to
access (through the purchase or obtaining of medicines) and consumption of these,
when comparing results of this paper an Australian team that described the
perspectives, attitudes, and behaviors of people towards antimicrobial resistance, they
agree that storage is closely related to an irrational prescription, changes in the
indicated therapy, excess of tablets for a single treatment and inadequate dispensing,
while in use it is related to protection in case of appearance of similar symptoms in
future illnesses (Lum et al., 2017).
Regarding the conditions where antibiotics and other medicines are stored, the
participants identify that avoiding direct light and high levels of heat and humidity
prevent these medicines from damaging their composition. This may be a belief
associated with food consumption as described by Khan et al. (2022), who through
interviews focused on knowing people's knowledge about the use of antibiotics report
that when consumed orally, medications must be kept under the same conditions. It is
important to establish that, even though these factors are known in most of the studies
that evaluate the knowledge and practices of drug storage, most of the results
(including those of this study) report that the most common storage space is the kitchen,
where high levels of light, humidity, and heat can be experienced (Sodric, 2020; Hussain
et al., 2019).
Likewise, the type and characteristics of the container stand out as areas of opportunity
in improving storage practices, since the participants do not identify that a container
with suitable characteristics can help keep their antibiotics in good condition. Eldalo,
Yousif, and Alotaibi (2020) establish, in a study aimed at evaluating the storage, uses,
and beliefs of medicines, that more than half of the participants identified that they
should have an exclusive container to store medicines to ensure the conditions of the
labels, prevent consumption in children and improve the monitoring of the quality of
the drug, especially in tablets and syrups.
On the characteristics of the home medication manager, it is important to highlight that
the participants describe that the administration of medications and antibiotics at home
is part of the functions of the main family caregiver, and this role is highly influenced by
gender, age, and the role played at home (older women, housewives), however, they
also express some essential competencies to carry out this activity related to
understanding the effect and characteristics of medication use. This topic is little
explored in research, some approaches such as that of Mohammed and Gorski (2021)
Marco Esteban Morales Rojas, Amairani Lucelly Ceh Alvarado, Didier Francisco Aké Canul, Sheila Mariela Cohuo Cob,
Maricela Balam Gómez5
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describe that the family caregiver must have knowledge of how to prevent and identify
infections, communicate the characteristics of the therapy (dose, time of consumption,
diet, etc.) and monitor any side effects of the administration of antibiotics.
It is important to point out that the above characteristics correspond to home
caregivers, who are usually not members of the family, and when the competencies of
family member caregivers are explored, traditionally the social and family burden falls
on women, setting higher expectations about their performance, which can create
discomfort, feelings of anxiety, and mistakes in the caregiver (Audiffred, 2022). On the
other hand, Lugova et al. (2020), identify that the knowledge of fathers versus mothers
in the management of respiratory infections at home is significantly higher in mothers,
which suggests a greater involvement of them in the care of illnesses at home.
Regarding the disposal of medicines, the findings are consistent with the conclusions
on the research by Galindo (2019) who mentions that people have notions about the
negative consequences for health and the environment that antibiotics can have when
throwing them away. without some previous care or treatment, however, it is not
possible to clarify the correct ways to do it. Likewise, the practices coincide in emptying
the medicines first, using home methods, and leaving them for garbage collection.
The management of antibiotics is established as a process that requires minimum
knowledge that adapts to the variable conditions of rural and urban areas, which will
depend on awareness, promotion, and shared information, therefore, the less practice
of these actions, the greater possibilities of errors in the use and proper disposal
(Galindo, 2019); This information is relevant, due to the different perceptions between
rural and urban areas, it was commented that in the former, reliable information that
could contribute to improving practices is not received.
In the description of improvements in the management of antibiotics, the perceptions
found are consistent with the recommendations issued in other investigations. For
example, Serrano, Pacheco, Mesa, and Rea (2019), reported that it is necessary to
disseminate available, close, and reliable information about the prescription,
dispensing, use, and management of antibiotics, which, in turn, can generate a
favorable change in behavior. However, this perception is contrasted, since in previous
years Llor (2010) established that strategies aimed at both doctors and patients, such
as discussion talks, computer alerts with reminders, or information brochures have
different results depending on the population with which they are concerned.
The perceptions of the interviewees about the areas of opportunity of the disposal
process by people who are not part of health teams and the responsibility of medical
personnel coincide with the needs and recommendations described by Seguí (2022)
who establishes that the doctor has their responsibility in terms of knowing the correct
way to dispose of leftover medication, he adds that doctors can contribute to educating
patients on the correct disposal of leftover medication and that every medical
prescription must include a legend on the correct way to dispose of it.
Qualitative study on antibiotic management in households: perception of family caregivers
Espirales. Revista multidisciplinaria de investigación científica, Vol. 7, No. 46
July - September 2023. e-ISSN 2550-6862. pp 65-82
76
Conclusions
People are aware of the informal management of medicines and recognize that they
can improve their practices, but they do not have recommendations or skills to gather
information and discern between appropriate and inappropriate management of
antibiotics.
Regarding access, people identify the role of pharmaceutical companies, by having
presentations with more doses than they need for a treatment, which automatically
leads to the storage of antibiotics and other medicines at home. Likewise, in the storage
of antibiotics, it is determined that it is closely related to access and a feeling of
uncertainty of being able to access them in the future, whether due to regulations, price
changes, or the time to go to consult, among others. Home caregivers perceive that the
management of antibiotics is a process that consumes time and entails a high
responsibility in the entire process, so they choose to keep them without a periodic
review with the feeling that they can be useful again, in case of present the same
symptoms, saving time and resources in accessing them.
The sociodemographic characteristics, specifically being a woman in adulthood, leads
to expectations about the activities that "should" be carried out, so the storage of
antibiotics generates a prompt solution to health problems that family members may
present. Perceptions are a starting point to knowing where to direct interventions to
change knowledge, behavior, and future public policies, since they are the guideline for
carrying out effective and contextualized activities on these issues, that is,
communication channels, media, and materials. diffusion, language to use, key actors
in the health team, among others. For the mitigation of antimicrobial resistance, it is
necessary to start with effective information that contains the minimum, basic, and
essential elements to guarantee that families can exercise care throughout the
management system, and the results presented are a first approach.
It is recommended to carry out this research with caregivers in rural areas to rescue
perceptions of this context, especially in access and storage of antibiotics. Likewise, to
observe if the phenomenon is related to individual variables (schooling, gender,
lifestyles, concomitant diseases, family socioeconomic level, among others) or the social
context (access to health services, private pharmacies, poverty, affordability, among
others).
..........................................................................................................
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