Knowledge, attitude, and practices of community pharmacy staff toward antimicrobial stewardship programs: a cross-sectional study from Northeastern China

Figures & data

Table 1. Characteristics of participants

Variable	Frequency	Percentage (%)
Gender
Male	16	4.1
Female	378	95.9
Ages(years)
20–29	110	27.9
30–39	138	35.1
40–49	106	26.9
≥50	40	10.1
Level of education
High school and below	106	26.9
Technical secondary school	121	30.7
College	126	32.0
Undergraduate	40	10.1
Graduate and above	1	0.3
Occupation
Manager	56	14.2
Licensed pharmacist	26	6.6
General staff	310	78.7
Other(volunteer)	2	0.5
Experience(years)
<5	218	55.4
5–10	111	28.2
11–15	38	9.6
>15	27	6.8
Type of pharmacy
Independent pharmacy	30	13.3
Chained pharmacy	196	86.7
Had a licensed pharmacist on duty
Yes	79	35.3
No	147	64.7

Table 2. Participants’ attitude toward antimicrobial stewardship programs

Variable	SD	DA	N	A	SA	Median (IQR)
ASPs should be incorporated at the community-pharmacy level	0 (0.0%)	1 (0.2%)	4 (1.0%)	98 (24.9%)	291 (73.9%)	5.00 (1)
ASPs reduce the problem of antimicrobial resistance	0 (0.0%)	1 (0.2%)	4 (1.0%)	98 (24.9%)	291 (73.9%)	5.00 (1)
Adequate training should be provided to community pharmacists on antimicrobial use	0 (0.0%)	16 (4.0%)	81 (20.6%)	137 (34.8%)	160 (40.6%)	4.00 (1)

strongly disagree (SD), disagree (DA), neutral (N), agree (A), and strongly agree (SA).

Table 3. Participants’ practices toward antimicrobials

Variable	Often N (%)	Occasionally N (%)	Never N (%)	Median (IQR)
In the past week, have you told patients about the adverse effects of using antimicrobials?	274 (69.5)	114 (28.9)	6 (1.6)	1.00 (1)
In the past week, have you given medication consultations to patients who bought antimicrobials at the pharmacy?	62 (15.7)	265 (67.3)	67 (17)	2.00 (0)
In the past week, have you sold antimicrobials to patients without a prescription?	2 (0.5)	160 (40.6)	232 (58.9)	3.00 (1)
In the past week, have you received patients who took a hospital prescription to buy antimicrobial drugs?	21 (5.3)	223 (56.6)	150 (38.1)	2.00 (1)

Table 4. Median scores of participants about their knowledge, attitude, and practices regarding ASPs

Variable	Category	Median Knowledge score (IQR)	P-value	Median attitude score (IQR)	P-value	Median practice score (IQR)	P-value
Gender*	Male	1(1)	0.716	5(1)	0.843	2(1)	0.291
	Female	1(1)		5(1)		2(1)
Ages (years) **	20–29	1(1)	0.769	5(1)	0.719	2(1)	<0.001
	30–39	1(1)		5(1)		2(1)
	40–49	1(1)		5(1)		2(1)
	≥50	1(1)		5(1)		2(1)
Level of education**	High school and below	1(1)	0.846	5(1)	0.246	2(1)	0.041
	Technical secondary school	1(1)		5(1)		2(1)
	College	1(1)		5(1)		2(1)
	Undergraduate	1(1)		5(1)		2(1)
	Graduate and above	1(-)		-		-
Occupation**	Manager	1(1)	0.636	5(1)	0.323	2(1)	<0.001
	Licensed pharmacist	1(1)		5(1)		2(1)
	General staff	1(1)		5(1)		2(1)
	Other	1(0)		5(1)		2(1)
Experience (years) **	<5	1(1)		5(1)	0.284	2(1)	<0.001
	5–10	1(1)	0.595	5(1)		2(1)
	11–15	1(1)		5(1)		2(1)
	>15	1(1)		5(1)		2(0)
Type of pharmacy**	Independent pharmacy	1(1)	0.917	5(1)	0.703	2(1)	0.273
	Chained pharmacy	1(1)		5(1)		2(1)
Had a licensed pharmacist on duty*	Yes	1(1)	0.958	5(1)	0.978	2(1)	0.102
	No	1(1)		5(1)		2(1)

Note: *Independent-sample Mann–Whitney U test; **independent-sample Kruskal–Wallis test.

Table 5. Logistic regression analysis of factors associated with the extent of understanding of antimicrobial stewardship policy

Variable	Category	Extent					OR	95% CI	P-value
		SDU	DU	N	U	SU
Gender	Male	3	5	6	0	2	1.153	0.430–3.093	0.777
	Female	52	197	99	19	11	1	-	-
Ages(years)	20–29	15	52	41	0	2	0.706	0.232–2.152	0.540
	30–39	22	77	29	7	3	0.629	0.233–1.697	0.360
	40–49	16	51	26	7	6	0.807	0.344–1.894	0.622
	>50	2	22	9	5	2	1	0-	-
Level of education	High school and below	19	49	24	10	4	4.259E-11	0-	0.999
	Technical secondary school	15	72	28	3	3	4.565E-11	0-	0.999
	College	18	69	36	3	0	5.231E-11	0-	0.999
	Undergraduate	3	12	17	3	5	1.552E-10	0-	0.999
	Graduate and above	0	0	0	0	1	1	-	-
Occupation	Manager	9	22	13	6	6	22.568	1.281–397.537	0.033
	Licensed pharmacist	1	7	10	5	3	46.327	2.443–878.451	0.011
	General staff	44	172	82	8	4	11.356	0.680–189.597	0.091
	Other	1	1	0	0	0	1	-	-
Experience (years)	<5	30	114	67	4	3	1.213	0.385–3.821	0.741
	5–10	19	57	24	6	5	0.958	0.340–2.700	0.935
	11–15	3	16	11	4	4	1.856	0.659–5.232	0.242
	>15	3	15	3	5	1	1	-	-
Type of pharmacy	Independent pharmacy	15	24	15	2	4	0.746	0.433–1.287	0.293
	Chained pharmacy	39	178	90	17	9	1	-	-
Had a licensed pharmacist on duty	Yes	18	57	39	13	12	1.398	0.898–2.175	0.138
	No	37	145	66	6	1	1	-	-

Abbreviation: OR, odds ratio. SDU, strongly don’t understand. DU, don’t understand. N, neutral. U, understand. SD, strongly understand.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.