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Gyawali R, Gamboa S, Rolfe K, Westbrook JI, Raban MZ. Consumer perspectives on antibiotic use in residential aged care: a mixed-methods systematic review. Am J Infect Control 2024:S0196-6553(24)00608-4. [PMID: 39067702 DOI: 10.1016/j.ajic.2024.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/12/2024] [Accepted: 07/14/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE Aged care staff and doctors frequently highlight consumers' role in antibiotic treatment decisions. However, few studies include consumers. This study aimed to investigate consumer perspectives on antibiotic use in residential aged care. METHODS A search across six online databases yielded 3373 studies, with five meeting inclusion criteria. Participant quotes, themes, statistical analyses, and authors' interpretive summaries in the included studies were inductively coded and refined to generate themes. RESULTS Three themes emerged: perception of benefits and risks of antibiotics; perceived role in antibiotic treatment decision-making and information-communication needs. Consumers held positive attitudes towards antibiotics, did not associate antibiotics with the exclusive treatment of bacterial infections, and had limited awareness of potential risks, such as antibiotic resistance. Studies showed diverse perceptions regarding residents' and their families' involvement in antibiotic treatment decision-making with some residents actively seeking antibiotics and others trusting doctors to decide. Studies also described consumer need for effective provider-consumer communication and information sharing which was affected by contextual barriers such as motivation, preferences, available information resources, and provider attitudes. CONCLUSION Limited literature is available on consumer perspectives on antibiotic use in aged care. The review highlights that consumer needs are more complex than simply wanting an antibiotic. Antimicrobial stewardship programs should target consumer awareness, beliefs and provider-consumer communication to enhance antibiotic use in aged care.
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Affiliation(s)
- Rajendra Gyawali
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University
| | - Sarah Gamboa
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University
| | - Kathleen Rolfe
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University
| | - Johanna I Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University
| | - Magdalena Z Raban
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University
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2
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Alhur A, Alghamdi L, Alqahtani F, Alshammari M, Hattany H, Akshah A, Al Ahmary A, Aloqran R, Olagi E, Alshahrani NS, Al-Qahtani R, Alqahtani J, Alghamdi L, Alharbi A, Alshokani S. A Study of Awareness, Knowledge, Attitudes, and Practices Regarding Antibiotic Resistance. Cureus 2024; 16:e62854. [PMID: 39036208 PMCID: PMC11260439 DOI: 10.7759/cureus.62854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2024] [Indexed: 07/23/2024] Open
Abstract
Background Antibiotic resistance is a critical global health concern, intensified by public misconceptions and inconsistent antibiotic use. Misunderstandings about antibiotics and their improper use contribute to the acceleration of resistance, making it harder to treat infections effectively. Previous research has identified knowledge gaps in the public, yet there is limited understanding of how these gaps translate into attitudes and practices across different demographic groups. This study aimed to assess the levels of knowledge, attitudes, and practices regarding antibiotic resistance among various demographic groups and to determine the influence of demographic factors on these variables. Methods A descriptive study was conducted using a structured online questionnaire distributed through social media and health forums. The questionnaire targeted adults aged 18 years and older from diverse socioeconomic backgrounds. Data were analyzed using SPSS version 26 (Armonk, NY: IBM Corp.) for descriptive statistics, chi-square tests, and logistic regression analysis. Results The study included responses from 1,561 participants, revealing that 75.72% had knowledge of antibiotic resistance, but only 68.23% understood its public health implications. Attitudes toward antibiotic use were generally positive, with 90.14% recognizing the importance of completing antibiotic courses. However, 32.16% admitted they would stop taking antibiotics once feeling better, even if the course was not finished, highlighting a significant gap between knowledge and practice. Regression analysis identified awareness of prevention measures (coefficient=2.06) and knowledge of antibiotic resistance (coefficient=1.38) as strong predictors of awareness. The chi-square test showed a significant association between gender and awareness of prevention measures (chi-square value=15.19, p-value=0.000097). Conclusions Despite a high level of knowledge about antibiotic resistance, gaps in attitudes and practices persist. These findings underscore the necessity for tailored educational campaigns that not only inform but also engage and alter behaviors across all demographic groups to combat antibiotic resistance effectively.
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Affiliation(s)
- Anas Alhur
- Health Informatics, University of Hail, College of Public Health and Health Informatics, Hail, SAU
| | - Lama Alghamdi
- Clinical Pharmacy, College of Pharmacy, Al-Baha University, Al-Baha, SAU
| | - Fay Alqahtani
- Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, SAU
| | - Milaf Alshammari
- Clinical Pharmacy, College of Pharmacy, University of Hafr Albatin, Hafr Albatin, SAU
| | - Halimah Hattany
- Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, SAU
| | - Abdulrahman Akshah
- Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, SAU
| | - Atyaf Al Ahmary
- Clinical Pharmacy, College of Pharmacy, University of Hafar Albatin, Hafar Albatin, SAU
| | - Rawan Aloqran
- Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, SAU
| | - Ebtehal Olagi
- Laboratory Medicine, Armed Forces Hospitals Southern Region (AFHSR), Khamis Mushait, SAU
| | | | - Reem Al-Qahtani
- Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, SAU
| | - Joud Alqahtani
- Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, SAU
| | - Lena Alghamdi
- Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, SAU
| | - Abdullah Alharbi
- Clinical Pharmacy, College of Pharmacy, University of Hafr Albatin, Hafr Albatin, SAU
| | - Shahad Alshokani
- Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, SAU
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Baillie EJ, Merlo G, Van Driel ML, Magin PJ, Hall L. Early-career general practitioners' antibiotic prescribing for acute infections: a systematic review. J Antimicrob Chemother 2024; 79:512-525. [PMID: 38252922 PMCID: PMC10904722 DOI: 10.1093/jac/dkae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Antimicrobial resistance is a worldwide threat, exacerbated by inappropriate prescribing. Most antibiotic prescribing occurs in primary care. Early-career GPs are important for the future of antibiotic prescribing and curbing antimicrobial resistance. OBJECTIVES To determine antibiotic prescribing patterns by early-career GPs for common acute infections. METHODS A systematic literature search was conducted using PubMed, Embase and Scopus. Two authors independently screened abstracts and full texts for inclusion. Primary outcomes were antibiotic prescribing rates for common acute infections by GPs with experience of 10 years or less. Secondary outcomes were any associations between working experience and antibiotic prescribing. RESULTS Of 1483 records retrieved, we identified 41 relevant studies. Early-career GPs were less likely to prescribe antibiotics compared with their more experienced colleagues (OR range 0.23-0.67). Their antibiotic prescribing rates for 'any respiratory condition' ranged from 14.6% to 52%, and for upper respiratory tract infections from 13.5% to 33%. Prescribing for acute bronchitis varied by country, from 15.9% in Sweden to 26% in the USA and 63%-73% in Australia. Condition-specific data for all other included acute infections, such as sinusitis and acute otitis media, were limited to the Australian context. CONCLUSIONS Early-career GPs prescribe fewer antibiotics than later-career GPs. However, there are still significant improvements to be made for common acute conditions, as their prescribing is higher than recommended benchmarks. Addressing antimicrobial resistance requires an ongoing worldwide effort and early-career GPs should be the target for long-term change.
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Affiliation(s)
- Emma J Baillie
- General Practice Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Greg Merlo
- General Practice Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Mieke L Van Driel
- General Practice Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Parker J Magin
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- GP Training Research Department, Royal Australian College of General Practitioners, Callaghan, NSW, Australia
| | - Lisa Hall
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
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4
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Chan OSK, Lam W, Zhao S, Tun H, Liu P, Wu P. Why prescribe antibiotics? A systematic review of knowledge, tension, and motivation among clinicians in low-, middle- and high-income countries. Soc Sci Med 2024; 345:116600. [PMID: 38394944 DOI: 10.1016/j.socscimed.2024.116600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 02/25/2024]
Abstract
Medical professionals such as physicians and veterinarians are responsible for appropriate antimicrobial prescription (AMP) and use. Although seemingly straightforward, the factors influencing antibiotic prescription, a category of antimicrobials, are complex. Many studies have been conducted in the past two decades on this subject. As a result, there is a plethora of empirical evidence regarding the factors influencing clinicians' AMP practices. AIM A systematic review of AMR studies on AMP was conducted, condensing findings according to a combination of the Knowledge, Attitude, and Practice (KAP) and Capacity, Opportunity, Motivation-Behavior (COM-B) models. Review findings were then synthesized and analyzed for policy implementation according to the Consolidated Framework for Implementation Research (CFIR). DESIGN AND METHODOLOGY A systematic literature review was conducted according to PRISMA guidelines to identify peer-reviewed papers indexed in pre-determined medical science, social sciences, and humanities databases that apply the KAP model in their investigations. Antimicrobial prescription factors were compared and contrasted among low- and middle-income countries (LMICs) and high-income countries (HICs). FINDINGS The KAP model is a heuristic and structured framework for identifying and classifying respondents' knowledge. However, other than medical knowledge, factors that influence prescription decision-making can be expanded to include attitudes, perception, personal affinities, professional circumstances, relational pressure, and social norms.
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Affiliation(s)
- Olivia S K Chan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Wendy Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Shilin Zhao
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong Special Administrative Region, China.
| | - Hein Tun
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong Special Administrative Region, China.
| | - Ping Liu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Peng Wu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
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Alejandro AL, Leo WWC, Bruce M. Opportunities to Improve Awareness of Antimicrobial Resistance Through Social Marketing: A Systematic Review of Interventions Targeting Parents and Children. HEALTH COMMUNICATION 2023; 38:3376-3392. [PMID: 36437539 DOI: 10.1080/10410236.2022.2149132] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Lack of knowledge from parents concerning the appropriate use of antimicrobials leads to poor treatment choices and mismanagement of antimicrobials for their children. Social marketing (SM) strategies have the potential to help parents access useful information on the appropriate use of antimicrobials. Still, its application in interventions targeting antimicrobial/antibiotic resistance awareness is minimal. This study explores the use of SM in antimicrobial/antibiotic awareness campaigns (AACs) to identify opportunities for SM approaches in developing future communication interventions targeting parents and children. We conduct a systematic review of interventions targeting parents and children between 2000 and 2022. Articles meeting the selection criteria were assessed against social marketing benchmark criteria (SMBC). We identified 6978 original records, 16 of which were included in the final review. None of the articles explicitly identified SM as part of their interventions. Twelve interventions (75%) included 1 to 4 (out of 8) benchmark criteria, while four (25%) had 5-8 benchmarks in their interventions. Of the interventions with less than four benchmark criteria, six studies (50%) reported a positive effect direction outcome, and six studies (50%) reported negative/no change direction on the outcome of interests. Meanwhile, all interventions with five or more SMBC resulted in a positive effect direction in their outcomes. In this review, the use of SM has shown promising results, indicating opportunities for future antimicrobial resistance (AMR) interventions that incorporate social marketing benchmark criteria to improve intervention outcomes.
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Affiliation(s)
- Aaron Lapuz Alejandro
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University
- Department of Nursing, Fiona Stanley Hospital
| | | | - Mieghan Bruce
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University
- School of Veterinary Medicine, Murdoch University
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Smith E, Buchan S. Skewed perception of personal behaviour as a contributor to antibiotic resistance and underestimation of the risks. PLoS One 2023; 18:e0293186. [PMID: 37917754 PMCID: PMC10621963 DOI: 10.1371/journal.pone.0293186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/08/2023] [Indexed: 11/04/2023] Open
Abstract
The increasing prevalence of antibiotic-resistant bacteria poses a significant threat to global human health. Countering this threat requires the public to understand the causes of, and risks posed by, antibiotic resistance (AR) to support changing healthcare and societal approaches to antibiotic use. To gauge public knowledge, we designed a questionnaire to assess awareness of causes of AR (both personal and societal) and knowledge of absolute and relative risks posed by antibiotic-resistant bacteria. Our findings reveal that while >90% respondents recognized personal behaviours as limiting AR, few individuals recognized the importance of societal factors e.g. the use of antibiotics in livestock. Furthermore, more respondents named viruses (either by name or as a group) than bacteria as reasons to take antibiotics, indicating lack of understanding. The absolute numbers of current and predicted future deaths attributed to antibiotic-resistant bacteria were under-estimated and respondents were more concerned about climate change and cancer than AR across all age groups and educational backgrounds. Our data reveal that despite heightened public awareness of infection-control measures following the COVID-19 pandemic, there remains a knowledge gap related to contributors and impacts of increasing numbers of antibiotic-resistant bacteria.
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Affiliation(s)
- Emily Smith
- Department of Life and Environmental Science, Bournemouth University, Poole, United Kingdom
| | - Sarah Buchan
- Department of Life and Environmental Science, Bournemouth University, Poole, United Kingdom
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7
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O'Shea SD, Pope R, Freire K, Orr R, Maj NG. Genitourinary infections in Australian servicewomen. Neurourol Urodyn 2023; 42:1668-1675. [PMID: 37497871 DOI: 10.1002/nau.25252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/09/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Genitourinary infections, including those associated with the urinary tract (urinary tract infection [UTI]) and vulvovaginal region, are common in women, affecting approximately one-third of biological females. A growing female military workforce necessitates consideration of their genitourinary health risks and needs to support and enhance their occupational health, safety, and performance. METHOD The pelvic health of active-duty servicewomen in the Australian Defense Force (ADF) was explored using an online cross-sectional survey. For the purposes of this study, only data related to genitourinary infections were extracted. The data were descriptively analysed to provide estimates of period prevalence rates. Risk factors and prevention and management strategies utilized were identified and described. RESULTS Of the 491 servicewomen who provided survey responses, 41% (95% confidence interval [CI]: 37%-46%) reported experiencing at least one UTI and 32% (95% CI: 28%-36%) reported experiencing regular symptoms of vulvovaginal irritation during their last period of active-duty service. Service arm, length of service, and history of participation in field activities or deployment were not substantially associated with prevalence estimates. Medical assessment was the most common diagnostic strategy for UTI and antibiotics were the most common management strategy. CONCLUSION Genitourinary infections are common in female ADF personnel and may impact on occupational health and performance. Therefore, organization-wide prevention and management approaches may be an important strategy for reducing the impact on personnel, their units and mission objectives, by reducing working days lost, utilization of health services and minimizing risks in more austere military environments.
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Affiliation(s)
- Simone D O'Shea
- Physiotherapy Program, School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Albury, New South Wales, Australia
| | - Rod Pope
- Physiotherapy Program, School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Albury, New South Wales, Australia
- Faculty of Health Sciences and Medicine, Tactical Research Unit, Bond University, Robina, Queensland, Australia
| | - Katharine Freire
- Three Rivers Department of Rural Health, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Robin Orr
- Faculty of Health Sciences and Medicine, Tactical Research Unit, Bond University, Robina, Queensland, Australia
| | - Naomi Gallagher Maj
- 4th Health Battalion, Royal Australian Army Nursing Corps, Australian Army, Townsville, Queensland, Australia
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8
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Degeling C, Yarwood T, Nettel-Aguirre A, Mullan J, Reynolds N, Chen G. Exploring the Preferences of the Australian Public for Antibiotic Treatments: A Discrete Choice Experiment. THE PATIENT 2023; 16:555-567. [PMID: 37462880 PMCID: PMC10409829 DOI: 10.1007/s40271-023-00640-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVES Identify Australian public preferences for antibiotic treatments in the context of antibiotic stewardship. METHODS A discrete choice experiment (DCE) was conducted in Australia to investigate the importance of seven attributes associated with antibiotic treatments and related stewardship practices: contribution to antimicrobial resistance (AMR), treatment duration, side effects, days needed to recover, days before taking antibiotics, treatment failure and out-of-pocket costs. The DCE data were analysed using conditional logit, mixed logit and latent class conditional logit models. The relative importance of each attribute was calculated. RESULTS A total of 1882 respondents completed the survey; the main study sample consist of 1658 respondents (mean age 48 years) who passed quality checks. All seven attributes significantly influenced respondents' preferences for antibiotic treatments. Based on the designed attribute levels in the DCE, on average, out-of-pocket costs (32.8%) and contribution to antibiotic resistance (30.3%) were the most important attributes, followed by side effects (12.9%). Days before starting medication was least important (3.9%). Three latent classes were identified. Class 1 (including respondents who were more likely to be older and more health literate; 24.5%) gave contribution to antibiotic resistance greater importance in treatment preferences. Class 2 (including respondents more likely to report poorer health; 25.2%) gave out-of-pocket costs greater importance. The remaining (50.4%), who were generally healthier, perceived side effects as the most important attribute. CONCLUSIONS Despite concerted public awareness raising campaigns, our results suggest that several factors may influence the preferences of Australians when considering antibiotic use. However, for those more likely to be aware of the need to preserve antibiotics, out-of-pocket costs and limiting the contribution to antibiotic resistance are the dominant influence. Delays in starting treatment were not important for any latent class, suggesting public tolerance for this measure. These results could help inform strategies to promote prudent antibiotic stewardship.
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Affiliation(s)
- Chris Degeling
- Australian Centre for Health Engagement Evidence and Values, University of Wollongong, Wollongong, NSW 2522 Australia
| | - Trent Yarwood
- Cairns and Hinterland Hospital and Health Service, Cairns, QLD Australia
- Cairns Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, Australia
- Rural Clinical School, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Alberto Nettel-Aguirre
- Centre for Health and Social Analytics, University of Wollongong, NIASRA, Wollongong, NSW 2522 Australia
| | - Judy Mullan
- Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW Australia
| | - Nina Reynolds
- School of Business, Faculty of Business and Law, University of Wollongong, Wollongong, NSW Australia
| | - Gang Chen
- Centre for Health Economics, Monash University, Monash Business School, Melbourne, Australia
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Patel V, Chadwick S, Bakhit M, Hawksworth G, Aldeyab MA. Whiteboard animation videos for increasing awareness about antimicrobial resistance, prudent antimicrobial prescribing, and urinary tract infection prevention. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e101. [PMID: 37396198 PMCID: PMC10311686 DOI: 10.1017/ash.2023.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 07/04/2023]
Affiliation(s)
- Vinesh Patel
- Department of Microbiology, Mid-Yorkshire Hospitals NHS Trust, Pinderfields Hospital, Wakefield, United Kingdom
- West Yorkshire Health and Care Partnership, Wakefield, United Kingdom
| | - Sarah Chadwick
- West Yorkshire Health and Care Partnership, Wakefield, United Kingdom
| | - Mina Bakhit
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | - Gillian Hawksworth
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom
| | - Mamoon A. Aldeyab
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom
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10
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Tull F, Bamert RS, Smith L, Goodwin D, Lambert K. Identifying and Prioritising Behaviours to Slow Antimicrobial Resistance. Antibiotics (Basel) 2023; 12:949. [PMID: 37370268 DOI: 10.3390/antibiotics12060949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 06/29/2023] Open
Abstract
As a nation with relatively low levels of AMR, due to both community and agricultural stewardship, as well as geographical isolation, Australia is somewhat unique. As this advantage is being eroded, this project aimed to investigate the spectrum of human behaviours that could be modified in order to slow the spread of AMR, building upon the argument that doable actions are the best-targeted and least complex to change. We conducted a workshop with a panel of diverse interdisciplinary AMR experts (from sociology, microbiology, agriculture, veterinary medicine, health and government) and identified twelve behaviours that, if undertaken by the public, would slow the spread of AMR. These were then assessed by a representative sample of the public (285 Australians) for current participation, likelihood of future participation (likelihood) and perceived benefits that could occur if undertaken (perceived impact). An impact-likelihood matrix was used to identify four priority behaviours: do not pressure your doctor for antibiotics; contact council to find out where you can safely dispose of cleaning products with antimicrobial marketing; lobby supermarkets to only sell antibiotic free meat products; and return unused antibiotics to a pharmacy. Among a multitude of behavioural options, this study also highlights the importance of tailoring doable actions to local conditions, increasing community education, and emphasizing the lack of a one-size fits all approach to tackling this global threat.
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Affiliation(s)
- Fraser Tull
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Melbourne 3170, Australia
| | - Rebecca S Bamert
- Centre to Impact AMR, Monash University, Melbourne 3170, Australia
| | - Liam Smith
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Melbourne 3170, Australia
| | - Denise Goodwin
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Melbourne 3170, Australia
| | - Karen Lambert
- Faculty of Education, Monash University, Melbourne 3170, Australia
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11
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Borelli E, Ellis K, Tomlinson M, Hotchkiss E. Antimicrobial usage and resistance in scottish dairy herds: a survey of farmers' knowledge, behaviours and attitudes. BMC Vet Res 2023; 19:72. [PMID: 37208702 DOI: 10.1186/s12917-023-03625-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 05/12/2023] [Indexed: 05/21/2023] Open
Abstract
Antimicrobial resistance (AMR) poses a major threat to global health. Understanding how antimicrobials are used on dairy farms and stakeholder beliefs relating to their use is essential to ensure responsible antimicrobial usage (AMU) to tackle the emergence of AMR. This study explored Scottish dairy farmers' knowledge about the meaning of AMR and antimicrobial activity, behaviour and practices related to farm AMU and attitudes towards AMR mitigation. An online survey was designed based on the findings of two focus groups and was completed by 61 respondents (7.3% of the total population of Scottish dairy farmers). Knowledge of antimicrobials and AMR was variable, and almost half of the participants believed that antimicrobials could have anti-inflammatory or analgesic activity. Veterinarians' opinions and advice about AMU were ranked significantly more important than other social referents or advisors. The majority of farmers (90%) reported having implemented practices to reduce reliance on antimicrobials (e.g., selective dry cow therapy, AMU treatment protocols) and having reduced farm AMU over recent years. Feeding waste milk to calves is still widespread, being reported by up to 30% of respondents. The main factors described to hinder responsible farm AMU were limited facilities (e.g., lack of isolation pens for sick animals) and knowledge of appropriate AMU recommendations, followed by time and financial constraints. Most farmers (89%) agreed that it is important to reduce AMU on dairy farms, but fewer (52%) acknowledged that AMU on UK dairy farms is currently too high, suggesting a mismatch between their intention to reduce antimicrobials and AMU behaviour. These results indicate that dairy farmers are aware of AMR, and their self-reported farm AMU has been reduced. However, some do not clearly comprehend the activity of antimicrobials and their correct usage. More work is needed to improve dairy farmers' knowledge of appropriate AMU and intentions to combat AMR. Farmers would benefit from more regular AMU discussions and advice from herd veterinarians, as they were described as highly trusted information resources. Training on how to reduce AMU should involve all farm staff administering antimicrobials and should be tailored to farm-specific barriers, such as limited facilities and workforce shortages.
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Affiliation(s)
- Elena Borelli
- School of Biodiversity, One Health and Veterinary Medicine, Scottish Centre for Production Animal & Food Safety, University of Glasgow, 464 Bearsden Rd, Bearsden, Glasgow, G61 1QH, UK.
| | - Kathryn Ellis
- School of Biodiversity, One Health and Veterinary Medicine, Scottish Centre for Production Animal & Food Safety, University of Glasgow, 464 Bearsden Rd, Bearsden, Glasgow, G61 1QH, UK
| | - Martin Tomlinson
- School of Biodiversity, One Health and Veterinary Medicine, Scottish Centre for Production Animal & Food Safety, University of Glasgow, 464 Bearsden Rd, Bearsden, Glasgow, G61 1QH, UK
| | - Emily Hotchkiss
- School of Biodiversity, One Health and Veterinary Medicine, Scottish Centre for Production Animal & Food Safety, University of Glasgow, 464 Bearsden Rd, Bearsden, Glasgow, G61 1QH, UK
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12
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Papanikolopoulou A, Gargalianos-Kakolyris P, Stoupis A, Moussas N, Pangalis A, Theodoridou K, Chronopoulou G, Pantazis N, Kantzanou M, Maltezou HC, Tsakris A. Carbapenem-Resistant Pseudomonas aeruginosa Bacteremia, through a Six-Year Infection Control Program in a Hospital. Microorganisms 2023; 11:1315. [PMID: 37317288 DOI: 10.3390/microorganisms11051315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/14/2023] [Accepted: 05/15/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a life-threatening healthcare-associated infection affecting especially patients with immunosuppression and comorbidities. We investigated the association between the incidence of CRPA bacteremia, antibiotic consumption, and infection control measures in a hospital during 2013-2018. METHODS We prospectively recorded the incidence of CRPA bacteremia, antibiotic consumption, use of hand-hygiene solutions, and isolation rates of multidrug-resistant (MDR) carrier patients. FINDINGS The consumption of colistin, aminoglycosides, and third-generation cephalosporins decreased significantly in the total hospital and its divisions (p-value < 0.001 for all comparisons) while the consumption of carbapenems decreased significantly in the adults ICU (p-value = 0.025). In addition, the incidence of CRPA significantly decreased in the total hospital clinics and departments (p-values = 0.027 and 0.042, respectively) and in adults clinics and departments (p-values = 0.031 and 0.051, respectively), while in the adults ICU, the incidence remained unchanged. Increased isolation rates of MDR carrier patients, even two months before, significantly correlated with decreased incidence of CRPA bacteremia (IRR: 0.20, 95% CI: 0.05-0.73, p-value = 0.015) in the adults ICU. Interestingly, when the use of hand-hygiene solutions (alcohol and/or scrub) increased, the consumption of advanced, nonadvanced, and all antibiotics decreased significantly. CONCLUSION In our hospital, multimodal infection control interventions resulted in a significant reduction of CRPA bacteremia, mostly due to the reduction of all classes of antibiotics.
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Affiliation(s)
- Amalia Papanikolopoulou
- Clinical Pharmacology Department, Athens Medical Center, 5-7 Distomou Str., 15125 Marousi, Greece
| | | | - Athina Stoupis
- Clinical Infectious Diseases Department, Athens Medical Center, 1 Delfon Str., 15125 Marousi, Greece
| | - Nikos Moussas
- Clinical Infectious Diseases Department, Athens Medical Center, 1 Delfon Str., 15125 Marousi, Greece
| | - Anastasia Pangalis
- Biopathology Department, Athens Medical Center, 5-7 Distomou Str., 15125 Marousi, Greece
| | - Kalliopi Theodoridou
- Department of Microbiology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Str., 11527 Athens, Greece
- Department of Microbiology, Andreas Syggros Hospital for Skin and Venereal Diseases, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Genovefa Chronopoulou
- Biopathology Department, Athens Medical Center, 5-7 Distomou Str., 15125 Marousi, Greece
| | - Nikos Pantazis
- Department of Hygiene, Epidemiology and Medical Statistics, Faculty of Medicine, School of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., 11527 Athens, Greece
| | - Maria Kantzanou
- Department of Microbiology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Str., 11527 Athens, Greece
| | - Helena C Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, 3-5 Agrafon Str., 15123 Athens, Greece
| | - Athanasios Tsakris
- Department of Microbiology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Str., 11527 Athens, Greece
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Sullman MJM, Lajunen TJ, Baddal B, Apostolou M. Antibiotics Knowledge, Attitudes and Behaviours among the Population Living in Cyprus. Antibiotics (Basel) 2023; 12:antibiotics12050897. [PMID: 37237800 DOI: 10.3390/antibiotics12050897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
This study investigated the knowledge, attitudes and behaviours towards antibiotics among the general public living in the Republic of Cyprus (RoC) and the Turkish Republic of Northern Cyprus (TRNC) by using an online questionnaire. Differences were examined using independent samples t-tests, chi-square tests, Mann-Whitney U tests and Spearman's rho. In total, 519 individuals completed the survey (RoC = 267, TRNC = 252), with an average age of 32.7, and 52.2% were female. Most citizens correctly identified paracetamol (TRNC = 93.7%, RoC = 53.9%) and ibuprofen (TRNC = 70.2%, RoC = 47.6%) as non-antibiotic medications. A substantial proportion thought antibiotics could treat viral infections, such as a cold (TRNC = 16.3%, RoC = 40.8%) or the flu (TRNC = 21.4%, RoC = 50.4%). Most participants understood that bacteria can become resistant to antibiotics (TRNC = 71.4%, RoC = 64.4%), that unnecessary use can lead to drug ineffectiveness (TRNC = 86.1%, RoC = 72.3%) and that they should always complete the course of antibiotics (TRNC = 85.7%, RoC = 64.0%). Positive attitudes towards antibiotics correlated negatively with knowledge in both samples, indicating that the more people know, the less positive their attitudes towards their use. The RoC appears to have tighter controls of over-the-counter (OTC) sales of antibiotics than TRNC. This study reveals that different communities can have varying levels of knowledge, attitudes and perceptions about antibiotic use. Tighter enforcement of the OTC regulations, educational efforts and media campaigns are needed for enhancing prudent antibiotic use on the island.
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Affiliation(s)
- Mark J M Sullman
- Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, Nicosia CY-1700, Cyprus
| | - Timo J Lajunen
- Department of Psychology, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
| | - Buket Baddal
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia 99138, Cyprus
| | - Menelaos Apostolou
- Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, Nicosia CY-1700, Cyprus
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14
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Schramm L, Byrne MK, Sweetnam T. Antibiotic Misuse Behaviours of Older People: Confirmation of the Factor Structure of the Antibiotic Use Questionnaire. Antibiotics (Basel) 2023; 12:antibiotics12040718. [PMID: 37107080 PMCID: PMC10135189 DOI: 10.3390/antibiotics12040718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/22/2023] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
Antibacterial resistance (AR) is responsible for steadily rising numbers of untreatable bacterial infections, most prevalently found in the older adult (OA) population due to age-related physical and cognitive deterioration, more frequent and long-lasting hospital visits, and reduced immunity. There are currently no established measures of antibiotic use behaviours for older adults, and theory-informed approaches to identifying the drivers of antibiotic use in older adults are lacking in the literature. The objective of this study was to identify predictors of antibiotic use and misuse in older adults using the Antibiotic Use Questionnaire (AUQ), a measure informed by the factors of the Theory of Planned Behaviour (TPB): attitudes and beliefs, social norms, perceived behavioural control, behaviour, and a covariate-knowledge. A measure of social desirability was included, and participants scoring highly were excluded to control for social desirability bias. Confirmatory Factor Analyses and regression analyses were conducted to test the hypotheses in a cross-sectional, anonymous survey. A total of 211 participants completed the survey, 47 of which were excluded due to incompletion and high social desirability scores (≥5). Results of the factor analysis confirmed that some (but not all) factors from previous research in the general population were confirmed in the OA sample. No factors were found to be significant predictors of antibiotic use behaviour. Several suggestions for the variance in results from that of the first study are suggested, including challenges with meeting requirement for statistical power. The paper concludes that further research is required to determine the validity of the AUQ in an older adult population.
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Affiliation(s)
- Loni Schramm
- Faculty of Health, Charles Darwin University, Darwin, NT 0909, Australia
| | - Mitchell K Byrne
- Faculty of Health, Charles Darwin University, Darwin, NT 0909, Australia
| | - Taylor Sweetnam
- Faculty of Health, Charles Darwin University, Darwin, NT 0909, Australia
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15
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Suttels V, Van Singer M, Clack LC, Plüss-Suard C, Niquille A, Mueller Y, Boillat Blanco N. Factors Influencing the Implementation of Antimicrobial Stewardship in Primary Care: A Narrative Review. Antibiotics (Basel) 2022; 12:antibiotics12010030. [PMID: 36671230 PMCID: PMC9854946 DOI: 10.3390/antibiotics12010030] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022] Open
Abstract
Antimicrobial resistance (AMR) is directly driven by inappropriate use of antibiotics. Although the majority of antibiotics (an estimated 80%) are consumed in primary care settings, antimicrobial stewardship (AMS) activities in primary care remain underdeveloped and factors influencing their implementation are poorly understood. This can result in promising stewardship activities having little-to-no real-world impact. With this narrative review, we aim to identify and summarize peer-reviewed literature reporting on (1) the nature and impact of AMS interventions in primary care and (2) the individual and contextual factors influencing their implementation. Reported activities included AMS at different contextual levels (individual, collective and policy). AMS activities being often combined, it is difficult to evaluate them as stand-alone interventions. While some important individual and contextual factors were reported (difficulty to reach physicians leading to a low uptake of interventions, tight workflow of physicians requiring implementation of flexible and brief interventions and AMS as a unique opportunity to strengthen physician-patients relationship), this review identified a paucity of information in the literature about the factors that support or hinder implementation of AMS in primary care settings. In conclusion, identifying multilevel barriers and facilitators for AMS uptake is an essential step to explore before implementing primary care AMS interventions.
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Affiliation(s)
- Véronique Suttels
- Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland
- Correspondence:
| | - Mathias Van Singer
- Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland
| | - Lauren Catherine Clack
- Institute for Implementation Science in Health Care, Medical Faculty, University of Zurich, 8006 Zürich, Switzerland
| | - Catherine Plüss-Suard
- Swiss Centre for Antibiotic Resistance, Institute for Infectious Diseases, University of Bern, 3001 Bern, Switzerland
| | - Anne Niquille
- Center for Primary Care and Public Health (Unisanté), Pharmacy University of Lausanne, 1011 Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Lausanne, 1011 Lausanne, Switzerland
| | - Yolanda Mueller
- Center for Primary Care and Public Health (Unisanté), Department of Family Medicine, 1011 Lausanne, Switzerland
| | - Noémie Boillat Blanco
- Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland
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16
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Crago AL, Alexandre S, Abdesselam K, Tropper DG, Hartmann M, Smith G, Lary T. Understanding Canadians' knowledge, attitudes and practices related to antimicrobial resistance and antibiotic use: Results from public opinion research. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2022; 48:550-558. [PMID: 38205428 PMCID: PMC10779429 DOI: 10.14745/ccdr.v48i1112a08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Antimicrobial resistance is a current and pressing issue in Canada. Population-level antibiotic consumption is a key driver. The Public Health Agency of Canada undertook a comprehensive assessment of the Canadian public's knowledge, attitudes and practices in relation to antimicrobial resistance and antibiotic use, to help inform the implementation of public awareness and knowledge mobilization. Methods Data were collected in three phases: 1) six in-person focus groups (53 participants) to help frame the survey; 2) nationwide survey administration to 1,515 Canadians 18 years and older via cell phone and landline; and 3) 12 online focus groups to analyze survey responses. Survey data is descriptive. Results A third (33.9%) of survey respondents reported using antibiotics at least once in the previous 12 months, 15.8% more than twice and 4.6% more than five times. Antibiotic use was reported more among 1) those with a household income below $60,000, 2) those with a medical condition, 3) those without a university education and 4) among the youngest adults (18-24 years of age) and (25-34 years of age). Misinformation about antibiotics was common: 32.5% said antibiotics "can kill viruses"; 27.9% said they are "effective against colds and flu"; and 45.8% said they are "effective in treating fungal infections". Inaccurate information was reported more often by those 1) aged 18-24 years, 2) with a high school degree or less and 3) with a household income below $60,000. In focus groups, the time/money trade-offs involved in accessing medical care were reported to contribute to pushing for a prescription or using unprescribed antibiotics, particularly in more remote contexts, while the cost of a prescription contributed to sharing and using old antibiotics. A large majority, across all demographic groups, followed the advice of medical professionals in making health decisions. Conclusion High trust in medical professionals presents an important opportunity for knowledge mobilization. Delayed prescriptions may alleviate concerns about the time/money constraints of accessing future care. Consideration should be given to prioritizing access to appropriate diagnostic and other technology for northern and/or remote communities and/or medical settings serving many young children to alleviate concerns of needing a prescription or of needing to return later.
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Affiliation(s)
- Anna-Louise Crago
- Antimicrobial Resistance Task Force of the Public Health Agency of Canada
| | | | - Kahina Abdesselam
- Antimicrobial Resistance Task Force of the Public Health Agency of Canada
| | | | - Michael Hartmann
- Antimicrobial Resistance Task Force of the Public Health Agency of Canada
| | - Glenys Smith
- Antimicrobial Resistance Task Force of the Public Health Agency of Canada
| | - Tanya Lary
- Antimicrobial Resistance Task Force of the Public Health Agency of Canada
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17
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Public knowledge, practices, and awareness of antibiotics and antibiotic resistance in Myanmar: The first national mobile phone panel survey. PLoS One 2022; 17:e0273380. [PMID: 35980986 PMCID: PMC9387831 DOI: 10.1371/journal.pone.0273380] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 08/07/2022] [Indexed: 11/19/2022] Open
Abstract
In 2017, the Myanmar National Action Plan for Containment of Antimicrobial Resistance (AMR) (2017–2022) was endorsed by the Ministry of Health and Sports, Myanmar; one of its objectives was to increase public awareness of AMR to accelerate appropriate antibiotic use. This survey aimed to assess the public knowledge, practices and awareness concerning antibiotics and AMR awareness among adults in Myanmar. We conducted a nationwide cross-sectional mobile phone panel survey in January and February 2020. Participants were randomly selected from the mobile phone panel in each of three groups stratified by gender, age group, and residential area urbanity; they were interviewed using a structured questionnaire. Collected data were weighted based on the population of each stratum from the latest national census and analyzed using descriptive and inferential statistics. Two thousand and forty-five adults from 12 regions and states participated in this survey. Overall, 89.5% of participants had heard about antibiotics; however, only 0.9% provided correct answers to all five questions about antibiotics, whereas 9.7% provided all incorrect answers. More than half of participants (58.5%) purchased antibiotics without a prescription, mainly from medical stores or pharmacies (87.9%); this was more frequent in age group (18–29 years) and those in rural areas (p = 0.004 and p < 0.001, respectively). Only 56.3% were aware of antibiotic resistance and received their information from medical professionals (46.3%), family members or friends (38.9%), or the media (26.1%). Less than half (42.4%) knew that antibiotics were used in farm animals. Most did not know that using antibiotics in farm animals could develop resistance (73.2%) and is banned for the purposes of growth stimulation (64.1%). This survey identifies considerable gaps in the knowledge, practices, and awareness about antibiotics among the general population in Myanmar. Continuous public education and awareness campaigns must be urgently conducted to fulfill these gaps, which would aid in promoting antibiotic stewardship, leading to combating AMR in Myanmar.
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18
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Wang L, Liang C, Yu H, Zhang H, Yan X. Reliability and validity evaluation of the appropriate antibiotic use self-efficacy scale for Chinese adults. BMC Public Health 2022; 22:1344. [PMID: 35836244 PMCID: PMC9284704 DOI: 10.1186/s12889-022-13729-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/04/2022] [Indexed: 11/21/2022] Open
Abstract
Background Antibiotic resistance is one of the greatest threats to global public health. Inappropriate use of antibiotics can lead to an increase in antibiotic resistance. Individual self-efficacy in the appropriate use of antibiotics plays a key role, especially in China where the population has easy access to antibiotics. However, there are no tools available to assess the self-efficacy of appropriate antibiotic use for Chinese adults. We aimed to translate and develop a Chinese version of the Appropriate Antibiotic Use Self-Efficacy Scale (AAUSES), and validate its reliability and validity. Methods A total of 659 adults were recruited to participate in the questionnaire. The original version scale was first translated into Chinese using the backward and forward translation procedures. The internal consistency reliability of the scale was measured by the Cronbach alpha coefficient, the test-retest reliability, and the corrected item-total correlation. The validity of the scale was assessed by the content validity index, exploratory factor analysis, and confirmatory factor analysis. Results The content validity index of the scale was 0.96. Exploratory factor analysis (EFA) supported a 4-factor structure of the translated questionnaire, and the discriminant validity of the scale was good. Confirmatory factor analysis (CFA) showed in the model fitness index, the chi-square degree of freedom was 2.940, the goodness-of-fit index(GFI) was 0.929, the incremental fit index (IFI) was 0.908, the comparative fit index(CFI) was 0.906, root mean square error of approximation(RMSEA) was 0.077, and standardized root mean residual (SRMR) was 0.0689, and the model fitting indexes were all in the acceptable range. Cronbach alpha coefficient for the scale was 0.910. The test-retest reliability was 0.947, and the corrected item-total correlations for the items ranged from 0.488 to 0.736. Self-efficacy for appropriate antibiotic use in adults varied by education, occupation, income, place of residence, and whether or not they had heard of antibiotic resistance. Conclusions The results indicated that the Chinese version of the AAUSES had good reliability and validity. Therefore, it can be considered a tool to evaluate the appropriate antibiotic use self-efficacy of adults in China.
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Affiliation(s)
- Liying Wang
- School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road, 121001, Jinzhou, China
| | - Chunguang Liang
- School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road, 121001, Jinzhou, China.
| | - Haitao Yu
- School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road, 121001, Jinzhou, China
| | - Hui Zhang
- School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road, 121001, Jinzhou, China
| | - Xiangru Yan
- School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road, 121001, Jinzhou, China
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19
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McNulty C, Read B, Quigley A, Verlander NQ, Lecky DM. What the public in England know about antibiotic use and resistance in 2020: a face-to-face questionnaire survey. BMJ Open 2022; 12:e055464. [PMID: 35387816 PMCID: PMC8987214 DOI: 10.1136/bmjopen-2021-055464] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To describe public attitudes and knowledge around antibiotic activity, resistance and use. DESIGN Face-to-face household 18 question survey using computer-assisted data collection undertaken by Ipsos Market and Opinion Research International. SETTING Randomly selected households across England, January-February 2020. PARTICIPANTS 2022 adults (aged 15+,) including 521 black, Asian and minority ethnic (BAME) participants, and 406 aged 15-25 years olds. MAIN OUTCOME MEASURES Responses to questions about antibiotic activity, resistance and expectations for antibiotics and trust in healthcare professionals. Analyses were weighted to obtain estimates representative of the population with multivariable analysis undertaken for questions with five or more significant univariate variables. RESULTS 84% stated they would be pleased if their general practitioner (GP) said they did not need antibiotics. Trust in GPs to make antibiotic decisions remains high (89%) and has increased for nurses (76%) and pharmacists (71%). Only 21% would challenge an antibiotic decision; this was significantly greater in BAME participants (OR 2.5; 95% CI 1.89 to 3.35). 70% reported receiving advice when prescribed antibiotics. Belief in benefits of antibiotics for ear infections was very high (68%). Similar to 2017, 81% agreed that antibiotics work for bacterial, 28% cold and influenza viruses. 84% agreed antibiotic resistant bacteria (ARB) are increasing, only 50% agreed healthy people can carry ARB and 39% agreed there was nothing they personally could do about ARB. Social grade DE and BAME participants, and those with less education had significantly less understanding about antibiotics and resistance. CONCLUSIONS As trust in healthcare practitioners is high, we need to continue antibiotic education and other interventions at GP surgeries and community pharmacies but highlight that most ear infections are not benefitted by antibiotics. Targeted interventions are needed for socioeconomic DE, BAME groups and previous antibiotic users. We need to explore if increasing perceived personal responsibility for preventing ARB reduces antibiotic use.
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Affiliation(s)
- Cliodna McNulty
- Primary Care and Interventions Unit, UK Health Security Agency, Gloucester, UK
| | - Brieze Read
- Primary Care and Interventions Unit, UK Health Security Agency, Gloucester, UK
| | - Anna Quigley
- Social Research Institute, Ipsos MORI UK Ltd, London, UK
| | - Neville Q Verlander
- Statistics, Modelling and Economics Department, UK Health Security Agency, London, UK
| | - Donna M Lecky
- Primary Care and Interventions Unit, UK Health Security Agency, Gloucester, UK
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