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Abstract

Background: Antimicrobial resistance (AMR), a major public health threat, is strongly associated with human antibiotic consumption. Influenza-like illnesses (ILI) account for substantial inappropriate antibiotic use; patient understanding and expectations probably play an important role. Aim: This study aimed to investigate what drives patient expectations of antibiotics for ILI and particularly whether AMR awareness, risk preferences (attitudes to taking risks with health) or time preferences (the extent to which people prioritise good health today over good health in the future) play a role. Methods: In 2015, a representative online panel survey of 2,064 adults in the United Kingdom was asked about antibiotic use and effectiveness for ILI. Explanatory variables in multivariable regression included AMR awareness, risk and time preferences and covariates. Results: The tendency not to prioritise immediate gain over later reward was independently strongly associated with greater awareness that antibiotics are inappropriate for ILI. Independently, believing antibiotics were effective for ILI and low AMR awareness significantly predicted reported antibiotic use. However, 272 (39%) of those with low AMR awareness said that the AMR information we provided would lead them to ask a doctor for antibiotics more often, significantly more than would do so less often, and in contrast to those with high AMR awareness (p < 0.0001). Conclusion: Information campaigns to reduce AMR may risk a paradoxical consequence of actually increasing public demand for antibiotics. Public antibiotic stewardship campaigns should be tested on a small scale before wider adoption.

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2018-06-21
2024-12-21
/content/10.2807/1560-7917.ES.2018.23.25.1700424
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References

  1. The Review on Antimicrobial Resistance. Antimicrobial resistance: tackling a crisis for the health and wealth of nations. London: UK Government; 2014. Available from: https://amr-review.org/sites/default/files/AMR%20Review%20Paper%20-%20Tackling%20a%20crisis%20for%20the%20health%20and%20wealth%20of%20nations_1.pdf
  2. Leeb M. Antibiotics: a shot in the arm. Nature. 2004;431(7011):892-3.  https://doi.org/10.1038/431892a  PMID: 15496888 
  3. Goossens H, Ferech M, Vander Stichele R, Elseviers MESAC Project Group. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet. 2005;365(9459):579-87.  https://doi.org/10.1016/S0140-6736(05)70799-6  PMID: 15708101 
  4. Bartlett JG. A call to arms: the imperative for antimicrobial stewardship. Clin Infect Dis. 2011;53(Suppl 1):S4-7.  https://doi.org/10.1093/cid/cir362  PMID: 21795727 
  5. Laxminarayan R. Antibiotic effectiveness: balancing conservation against innovation. Science. 2014;345(6202):1299-301.  https://doi.org/10.1126/science.1254163  PMID: 25214620 
  6. Low D. Reducing antibiotic use in influenza: challenges and rewards. Clin Microbiol Infect. 2008;14(4):298-306.  https://doi.org/10.1111/j.1469-0691.2007.01910.x  PMID: 18093237 
  7. Petersen I, Johnson AM, Islam A, Duckworth G, Livermore DM, Hayward AC. Protective effect of antibiotics against serious complications of common respiratory tract infections: retrospective cohort study with the UK General Practice Research Database. BMJ. 2007;335(7627):982.  https://doi.org/10.1136/bmj.39345.405243.BE  PMID: 17947744 
  8. Cockburn J, Pit S. Prescribing behaviour in clinical practice: patients’ expectations and doctors’ perceptions of patients’ expectations--a questionnaire study. BMJ. 1997;315(7107):520-3.  https://doi.org/10.1136/bmj.315.7107.520  PMID: 9329308 
  9. Coenen S, Michiels B, Renard D, Denekens J, Van Royen P. Antibiotic prescribing for acute cough: the effect of perceived patient demand. Br J Gen Pract. 2006;56(524):183-90. PMID: 16536958 
  10. Huttner B, Goossens H, Verheij T, Harbarth SCHAMP consortium. Characteristics and outcomes of public campaigns aimed at improving the use of antibiotics in outpatients in high-income countries. Lancet Infect Dis. 2010;10(1):17-31.  https://doi.org/10.1016/S1473-3099(09)70305-6  PMID: 20129146 
  11. McNulty CAM, Nichols T, French DP, Joshi P, Butler CC. Expectations for consultations and antibiotics for respiratory tract infection in primary care: the RTI clinical iceberg. Br J Gen Pract. 2013;63(612):e429-36.  https://doi.org/10.3399/bjgp13X669149  PMID: 23834879 
  12. Kang MI, Ikeda S. Time discounting and smoking behavior: evidence from a panel survey(*). Health Econ. 2014;23(12):1443-64.  https://doi.org/10.1002/hec.2998  PMID: 24136867 
  13. Picone G, Sloan F, Taylor D Jr. Effects of risk and time preference and expected longevity on demand for medical tests. J Risk Uncertain. 2004;28(1):39-53.  https://doi.org/10.1023/B:RISK.0000009435.11390.23 
  14. Anderson LR, Mellor JM. Predicting health behaviors with an experimental measure of risk preference. J Health Econ. 2008;27(5):1260-74.  https://doi.org/10.1016/j.jhealeco.2008.05.011  PMID: 18621427 
  15. Rammstedt B, John OP. Measuring personality in one minute or less: A 10-item short version of the Big Five Inventory in English and German. J Res Pers. 2007;41(1):203-12.  https://doi.org/10.1016/j.jrp.2006.02.001 
  16. What is Antibiotic Resistance and Why is it a problem? Boston: Alliance for the Prudent Use of Antibiotics (APUA). [Accessed Nov 2015]. Available from: http://www.tufts.edu/med/apua/about_issue/antibiotic_res.shtml
  17. World Health Organization (WHO). Antimicrobial resistance. Geneva; WHO; 2018. Available from: http://www.who.int/mediacentre/factsheets/fs194/en/
  18. Become an antibiotic guardian. London: Public Health England; [Accessed Nov 2015]. Available from: www.antibioticguardian.com
  19. The Antibiotic Awareness Campaign. London: NHS; 2015, http://www.nhs.uk/NHSEngland/ARC/Pages/AboutARC.aspx
  20. Dohmen T, Falk A, Huffman D, Sunde U, Schupp J, Wagner GG. Individual risk attitudes: Measurement, determinants, and behavioral consequences. J Eur Econ Assoc. 2011;9(3):522-50.  https://doi.org/10.1111/j.1542-4774.2011.01015.x 
  21. Jimura K, Myerson J, Hilgard J, Keighley J, Braver TS, Green L. Domain independence and stability in young and older adults’ discounting of delayed rewards. Behav Processes. 2011;87(3):253-9.  https://doi.org/10.1016/j.beproc.2011.04.006  PMID: 21550384 
  22. Nyhan B, Reifler J, Richey S, Freed GL. Effective messages in vaccine promotion: a randomized trial. Pediatrics. 2014;133(4):e835-42.  https://doi.org/10.1542/peds.2013-2365  PMID: 24590751 
  23. Cho H, Salmon CT. Unintended effects of health communication campaigns. J Commun. 2007;57(2):293-317.  https://doi.org/10.1111/j.1460-2466.2007.00344.x 
  24. Peters GJ, Ruiter RA, Kok G. Threatening communication: a critical re-analysis and a revised meta-analytic test of fear appeal theory. Health Psychol Rev. 2013;7(sup1) Suppl 1;S8-31.  https://doi.org/10.1080/17437199.2012.703527  PMID: 23772231 
  25. McCullough AR, Parekh S, Rathbone J, Del Mar CB, Hoffmann TC. A systematic review of the public’s knowledge and beliefs about antibiotic resistance. J Antimicrob Chemother. 2016;71(1):27-33.  https://doi.org/10.1093/jac/dkv310  PMID: 26459555 
  26. Goossens H, Guillemot D, Ferech M, Schlemmer B, Costers M, van Breda M, et al. National campaigns to improve antibiotic use. Eur J Clin Pharmacol. 2006;62(5):373-9.  https://doi.org/10.1007/s00228-005-0094-7  PMID: 16568344 
  27. Sabuncu E, David J, Bernède-Bauduin C, Pépin S, Leroy M, Boëlle PY, et al. Significant reduction of antibiotic use in the community after a nationwide campaign in France, 2002-2007. PLoS Med. 2009;6(6):e1000084.  https://doi.org/10.1371/journal.pmed.1000084  PMID: 19492093 
  28. Llewelyn MJ, Fitzpatrick JM, Darwin E, SarahTonkin-Crine, Gorton C, Paul J, et al. The antibiotic course has had its day. BMJ. 2017;358:j3418.  https://doi.org/10.1136/bmj.j3418  PMID: 28747365 
  29. McNulty CA, Boyle P, Nichols T, Clappison P, Davey P. Don’t wear me out--the public’s knowledge of and attitudes to antibiotic use. J Antimicrob Chemother. 2007;59(4):727-38.  https://doi.org/10.1093/jac/dkl558  PMID: 17307770 
  30. Smith RA, MacGeorge EL, Hackman NM, M’ikanatha NM. Campaign preparation for complex initiatives: a person-centred approach to audience segmentation of parents’ antibiotic stewardship. Health Commun. 2017;1-10.; Epub ahead of print.  https://doi.org/10.1080/10410236.2017.1384345 
Reducing demand for antibiotic prescriptions: evidence from an online survey of the general public on the interaction between preferences, beliefs and information, United Kingdom, 2015
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Laurence+S+J+Roope&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Roope Laurence S J</a>, <a href="/search?value1=Sarah+Tonkin-Crine&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tonkin-Crine Sarah</a>, <a href="/search?value1=Christopher+C+Butler&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Butler Christopher C</a>, <a href="/search?value1=Derrick+Crook&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Crook Derrick</a>, <a href="/search?value1=Tim+Peto&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Peto Tim</a>, <a href="/search?value1=Michele+Peters&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Peters Michele</a>, <a href="/search?value1=A+Sarah+Walker&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Walker A Sarah</a>, <a href="/search?value1=Sarah+Wordsworth&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wordsworth Sarah</a></span>. Reducing demand for antibiotic prescriptions: evidence from an online survey of the general public on the interaction between preferences, beliefs and information, United Kingdom, 2015. <a href="/content/ecdc">Euro Surveill.</a> 2018;23(25):pii=1700424. <a href="https://doi.org/10.2807/1560-7917.ES.2018.23.25.1700424" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2018.23.25.1700424</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 30 Jun 2017;&nbsp;&nbsp; <span class="generated">Accepted</span>: 19 Apr 2018 </span> </p>
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