Perspectives on Non-Prescription Antibiotic Use among Hispanic Patients in the Houston Metroplex

Lindsey Laytner; Patricia Chen; Susan Nash; Michael K. Paasche-Orlow; Richard Street; Roger Zoorob; Barbara Trautner; Larissa Grigoryan

doi:10.3122/jabfm.2022.220416R1

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Figure 1.
Overview of themes and subthemes across the patient, healthcare system, and clinical encounter domains that influence Hispanic patients' decisions to use antibiotics without a prescription.

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Table 1.

Sociodemographic Characteristics of Participants

Characteristic	Hispanics (Overall)	English-Speaking Hispanics	Spanish-Speaking Hispanics
Characteristic	(n = 35)	(n = 14)	(n = 21)
Median age
Year (range)	48 (27 to 66)	45 (29 to 66)	51 (27 to 63)
No. (%) of participant gender
Male	11 (31.4)	5 (35.7)	6 (28.6)
Female	24 (68.6)	9 (64.3)	15 (71.4)
No. (%) of participants with education level
Less than high school	10 (28.6)	0 (0)	10 (47.6)
High school or GED	14 (40.0)	8 (57.1)	6 (28.6)
Some college and above	11 (31.4)	6 (42.9)	5 (23.8)
No. (%) of participants with insurance
Private, Medicare	7 (20.0)	4 (28.6)	3 (14.3)
Medicaid, County Financial Assistance Program^*	27 (77.1)	10 (71.4)	17 (81.0)
Uninsured	1 (2.9)	0 (0)	1 (4.8)
No. (%) of participants attending a healthcare system
Private	1 (2.9)	1 (7.1)	0 (0)
Public	34 (97.1)	13 (92.9)	21 (100.0)
No. (%) of participants attending clinic type
Emergency Department	1 (2.9)	1 (7.1)	0 (0)
Walk in Clinic	25 (71.4)	9 (64.3)	16 (76.2)
Continuity Clinic	9 (25.7)	4 (28.6)	5 (23.8)
No. (%) of participants with income
<$20,000	19 (54.3)	8 (57.1)	11 (52.4)
≥$20,000 but <$40,000	9 (25.7)	3 (21.4)	6 (28.6)
≥$40,000 but <$60,000	2 (5.7)	1 (7.1)	1 (4.8)
≥$60,000 but <$100,000	1 (2.9)	1 (7.1)	0 (0)
I don't know/ prefer not to say	4 (11.4)	1 (7.1)	3 (14.3)
No. (%) of participants born in
United States (US)	10 (28.6)	9 (64.3)	1 (4.8)
Other^{^†}	25 (71.4)	5 (35.7)	20 (95.2)
Median years lived in the US for the participants born in other countries^{^†}
Year (range)	29.0 (1.5 to 59)	43.5 (29 to 66)	25 (27 to 63)
Overall health status^{^‡}	4 (1 to 5)	4 (2 to 5)	4 (1 to 5)
Median (range)
No. (%) with health literacy^{^§}
Adequate health literacy	24 (68.6)	10 (71.4)	14 (66.7)
Inadequate health literacy	11 (31.4)	4 (28.6)	7 (33.3)

↵* County (i.e., Harris Health) financial assistance program includes those who have benefits from the county, allowing access to public clinic providers at either very low cost or no cost.
↵^† Includes: 2 Cuba, 2 Guatemala, 5 Honduras, 15 México, 1 Panamá (countries are listed in alphabetical order).
↵^‡ Score ranges from 1 to 5 (excellent = 1; poor = 5), with lower scores being more favorable.¹⁶
↵^§ Calculated using the three questions from the Brief Health Literacy Screen measure.^17,18

Domain	Theme/Subtheme	Frequency of mentions
Patient factors	Caregiving responsibilities	5
	Work commitments	11
	Lack of transportation	28
	Doctor visit is unnecessary	27
	Alleviating symptoms similar to those of a prior illness	81
	Reducing illness severity	6
Healthcare system factors	Long clinic waits	11
	High costs of the doctor (visit and medications)	30
	Lack of insurance	12
	Ease of obtaining non-prescription antibiotics in:
	Informal social networks in the US, including friends/relatives	35
	Markets or yerberias	10
	Pharmacies abroad	22
	Purchasing from perceived trusted individuals	50
Clinical encounter factors	Communication difficulties with healthcare providers	13
	Language barriers	4
	Discourteous staff	3
	Disconnects in patient-provider communication	4
	Health literacy gaps	2