Non-prescribed antibiotic use and general practitioner service utilisation among Chinese migrants in Australia
Jie Hu A B and Zhiqiang Wang AA Centre for Chronic Disease, School of Medicine, University of Queensland, Herston, Qld 4029, Australia.
B Corresponding author. Email: j.hu1@uq.edu.au
Australian Journal of Primary Health 22(5) 434-439 https://doi.org/10.1071/PY15076
Submitted: 25 May 2015 Accepted: 2 August 2015 Published: 2 September 2015
Abstract
Non-prescribed antibiotic use occurs worldwide and is an important contributor to antibiotic resistance. Social and health system factors were related to the practice of self-medication with antibiotics. This study aims to investigate the practice of non-prescribed antibiotic use, and to assess the impact of primary health service access and use on this practice among Australian Chinese migrants. Four-hundred and twenty-six participants, who self-identified as Chinese and who had been residing in Australia for at least 12 months, were recruited through several Australian Chinese social websites to participate in an online health survey about antibiotic use and health services use from July to October 2013. Logistic regression analyses were conducted to assess the associations between health services utilisation factors and the use of non-prescribed antibiotics. In total, 20.2% (86/426) participants reported having used antibiotics without medical consultation in the last 12 months. Of 170 antibiotic users, 50.6% (86/170) used antibiotics without medical consultation. Chinese migrants who self-evaluated as ‘satisfied’ with the experiences of GP services were less likely to self-medicate with antibiotics. In addition, Chinese migrants without any perceived barriers to using primary health services in Australia were less likely to use non-prescribed antibiotics. Among Australian Chinese migrants, over half of antibiotic users admitted that they had used antibiotics without medical consultation. Participants with positive experience and perception of primary health services, primarily GP services, had a lower risk of using non-prescribed antibiotics.
Additional keywords: primary health service use.
References
Agudelo-Suárez AA, Gil-González D, Vives-Cases C, Love JG, Wimpenny P, Ronda-Pérez E (2012) A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services’ accessibility in economic migrants. BMC Health Services Research 12, 461| A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services’ accessibility in economic migrants.Crossref | GoogleScholarGoogle Scholar | 23245431PubMed |
Anikeeva O, Bi P, Hiller JE, Ryan P, Roder D, Han G-S (2010) Review paper: the health status of migrants in australia: a review. Asia-Pacific Journal of Public Health 22, 159–193.
| Review paper: the health status of migrants in australia: a review.Crossref | GoogleScholarGoogle Scholar | 20457648PubMed |
Australian Bureau of Statistics (ABS) (2013) Reflecting a nation: stories from the 2011 Census. Available at http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/2071.0main+features902012-2013 [Verified 2 December 2014]
Bagge M, Tordoff J, Norris P, Heydon S (2013) Older people’s attitudes towards their regular medicines. Journal of Primary Health Care 5, 234–242.
Cars O, Nordberg P (2005) Antibiotic resistance – the faceless threat. International Journal of Risk & Safety in Medicine 17, 103–110.
Céspedes A, Larson E (2006) Knowledge, attitudes, and practices regarding antibiotic use among Latinos in the United States: review and recommendations. American Journal of Infection Control 34, 495–502.
| Knowledge, attitudes, and practices regarding antibiotic use among Latinos in the United States: review and recommendations.Crossref | GoogleScholarGoogle Scholar | 17015154PubMed |
Choi BCK, Pak AWP (2005) A catalog of biases in questionnaires. Preventing Chronic Disease 2, A13
Grigoryan L, Burgerhof JG, Degener JE, Deschepper R, Lundborg CS, Monnet DL, Scicluna EA, Birkin J, Haaijer-Ruskamp FM (2008) Determinants of self-medication with antibiotics in Europe: the impact of beliefs, country wealth and the healthcare system. The Journal of Antimicrobial Chemotherapy 61, 1172–1179.
| Determinants of self-medication with antibiotics in Europe: the impact of beliefs, country wealth and the healthcare system.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD1cXksF2ltrw%3D&md5=e8590fb1698f1d8ebc9297b51a5179acCAS | 18296694PubMed |
Harbarth S, Monnet DL (2008) ‘Cultural and socioeconomic determinants of antibiotic use.’ (Springer: Boston, MA)
Health Care Consumers’ Association (HCCA) (2009) HCCA submission to GP Task Force 2009. Available at http://www.hcca.org.au/component/rsfiles/download?path=HCCA%20Submissions%202009/HCCA%20Submission%20to%20GP%20Taskforce%20-%20July%202009.pdf [Verified 20 June 2014]
Holmes NE, Howden BP (2011) The rise of antimicrobial resistance a clear and present danger. Expert Review of Anti-Infective Therapy 9, 645–648.
| The rise of antimicrobial resistance a clear and present danger.Crossref | GoogleScholarGoogle Scholar | 21692668PubMed |
Hu J, Wang Z (2014a) In-home antibiotic storage among Australian Chinese migrants. International Journal of Infectious Diseases 26, 103–106.
| In-home antibiotic storage among Australian Chinese migrants.Crossref | GoogleScholarGoogle Scholar | 25046273PubMed |
Hu J, Wang Z (2014b) Bringing antibiotics from overseas and self-medication amongst Australian Chinese migrants. Internet Journal of Infectious Disease 14,
| Bringing antibiotics from overseas and self-medication amongst Australian Chinese migrants.Crossref | GoogleScholarGoogle Scholar |
Hu J, Wang Z (2015) Knowledge, attitudes and perceptions regarding antibiotic use and self-medication: a cross-sectional study among Australian Chinese migrants. Healthcare Infection 20, 23–28.
| Knowledge, attitudes and perceptions regarding antibiotic use and self-medication: a cross-sectional study among Australian Chinese migrants.Crossref | GoogleScholarGoogle Scholar |
Hu J, Wong KC, Wang Z (2015) Recruiting migrants for health research through social network sites: an online survey among Chinese Migrants in Australia. JMIR Research Protocols 4, e46
| Recruiting migrants for health research through social network sites: an online survey among Chinese Migrants in Australia.Crossref | GoogleScholarGoogle Scholar | 25917837PubMed |
Li F, Xiong C, Cai J, Chang L, Wang X, Zen G, Fontaine RE (2008) Investigation of utilization situation of antibiotics among residents in Beijing. Modern Preventive Medicine 135, 1199–1201.
Liu YC, Huang WK, Huang TS, Kunin CM (2001) Inappropriate use of antibiotics and the risk for delayed admission and masked diagnosis of infectious diseases: a lesson from Taiwan. Archives of Internal Medicine 161, 2366–2370.
| Inappropriate use of antibiotics and the risk for delayed admission and masked diagnosis of infectious diseases: a lesson from Taiwan.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3Mnks1ygsg%3D%3D&md5=5bbdd18ae25dd7a92d2a599491dfeb85CAS | 11606153PubMed |
Mainous AG, Cheng AY, Garr RC, Tilley BC, Everett CJ, McKee MD (2005) Nonprescribed antimicrobial drugs in Latino community, South Carolina. Emerging Infectious Diseases 11, 883–888.
| Nonprescribed antimicrobial drugs in Latino community, South Carolina.Crossref | GoogleScholarGoogle Scholar | 15963283PubMed |
McNulty CAM, Boyle P, Nichols T, Clappison P, Davey P (2007) Don’t wear me out – the public’s knowledge of and attitudes to antibiotic use. The Journal of Antimicrobial Chemotherapy 59, 727–738.
| Don’t wear me out – the public’s knowledge of and attitudes to antibiotic use.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2sXltVKgsLs%3D&md5=6f2a06fbf1bc380948e086afe08f3da0CAS |
Morgan DJ, Okeke IN, Laxminarayan R, Perencevich EN, Weisenberg S (2011) Non-prescription antimicrobial use worldwide: a systematic review. The Lancet Infectious Diseases 11, 692–701.
| Non-prescription antimicrobial use worldwide: a systematic review.Crossref | GoogleScholarGoogle Scholar | 21659004PubMed |
Nelson A (2002) Unequal treatment: confronting racial and ethnic disparities in health care. Journal of the National Medical Association 94, 666–668.
Norris P, Ng L, Kershaw V, Hanna F, Wong A, Talekar M, Oh J, Azer M, Cheong L (2010) Knowledge and reported use of antibiotics amongst immigrant ethnic groups in New Zealand. Journal of Immigrant and Minority Health 12, 107–112.
| Knowledge and reported use of antibiotics amongst immigrant ethnic groups in New Zealand.Crossref | GoogleScholarGoogle Scholar | 19139990PubMed |
Pang EC, Jordan-Marsh M, Silverstein M, Cody M (2003) Health-seeking behaviors of elderly Chinese Americans: shifts in expectations. The Gerontologist 43, 864–874.
| Health-seeking behaviors of elderly Chinese Americans: shifts in expectations.Crossref | GoogleScholarGoogle Scholar | 14704386PubMed |
Scahill S, Vaughan C, Babar Z-U-d (2012) Ethnicity, migration and minority groups: medicines access and use in high-income economies. Southern Med Review 5, 1–2.
StataCorp (2013) ‘Stata Statisical Software: release 13.’ (StataCorp LP: College Station, TX)
World Health Organization (WHO) (2001) WHO global strategy for containment of antimicrobial resistance. WHO, Geneva, Switzerland.
World Health Organization (WHO) (2010) Fact sheet on antimicrobial resistance. Available at http://www.who.int/mediacentre/factsheets/fs194/en/print.html [Verified 22 June 2013]
Wutzke SE, Artist MA, Kehoe LA, Fletcher M, Mackson JM, Weekes LM (2007) Evaluation of a national programme to reduce inappropriate use of antibiotics for upper respiratory tract infections: effects on consumer awareness, beliefs, attitudes and behaviour in Australia. Health Promotion International 22, 53–64.
| Evaluation of a national programme to reduce inappropriate use of antibiotics for upper respiratory tract infections: effects on consumer awareness, beliefs, attitudes and behaviour in Australia.Crossref | GoogleScholarGoogle Scholar | 17046966PubMed |
