None listed
Conditions
Brief summary
Antimicrobial resistance (AMR) is a significant global challenge which poses a major threat to public health. The emergence and spread of antimicrobial-resistant bacteria is accelerated by overprescription of antibiotics; a significant contributor is the profligate use of antibiotics in primary care. In New Zealand, community dispensing accounts for significant proportion of human use of antibiotics. The level of outpatient antimicrobial consumption in NZ is comparable to that of countries such as Italy and Spain that are reported to have excessive levels of antibiotic consumption, and as a result, high levels of AMR (Thomas, et al. 2014). In an effort to understand why excessive antibiotic prescription occurs in the GP setting, attention has been drawn to factors related to the consultation and how the patient-physician interaction may facilitate inappropriate prescribing. In fact, Mehrotra and Linder (2016) highlight that ‘the overuse of antibiotics is largely a psychological problem’, whereby perceptions of the physician and patient play a major role in driving inappropriate prescribing. In this study we aim to examine the impact of primary care patients’ knowledge/attitudes towards antibiotics on antibiotic prescribing. We will also aim to test the impact of different types of antibiotic related information (namely, i) side effects and ii) antimicrobial resistance) on patient expectations and levels of ABx prescribing. This information will be delivered to patients in the GP waiting room, prior to their consultation. Antibiotic overuse and consequent development of AMR is an issue of significant relevance to to health of New Zealanders. Thus, we believe study findings will have important implications, particularly with regard to informing development of patient-focused interventions to reduce use of antibiotics, both at a primary care and public health level. Results are also likely to provide valuable information to GPs on types of information which can be used to educate and modify patient expectations for antibiotics in the consultation.
Interventions
The intervention will be delivered in the practice waiting room via a smart-tablet. The intervention will be delivered individually to each participant over approximately a 5 minute period. The intervention will be delivered at Balmoral Doctors (a ProCare affiliated general practice) in Auckland, New Zealand.
Participants are: patients with upper respiratory tract symptoms of common cold/flu and parents of patients aged 0-7years with upper respiratory tract symptoms who are in the general prac
The intervention will be delivered in the practice waiting room via a smart-tablet. The intervention will be delivered individually to each participant over approximately a 5 minute period. The intervention will be delivered at Balmoral Doctors (a ProCare affiliated general practice) in Auckland, New Zealand. Participants are: patients with upper respiratory tract symptoms of common cold/flu and parents of patients aged 0-7years with upper respiratory tract symptoms who are in the general practice waiting room. Each participant will be asked to complete a brief baseline questionnaire. Once this is done each participant will be randomised into one of three groups: Group 1: Minimal efficacy and antimicrobial resistance [AMR] information, or Group 2: Adverse effect information, or Group 3: Active Control Participants will receive the relevant information in the practice waiting room before their/their child’s appointment. The information will be delivered primarily in a written format. Given the capabilities of tablet technology, in addition to written information, content will also be delivered using static and dynamic visual imagery. Features which facilitate participant interaction with the tablet device (e.g. tapping on buttons) will also be integrated. MINIMAL EFFICACY/AMR GROUP: Participants in this group will receive information highlighting the lack of efficacy of antibiotic treatment for colds/flu. It will also be highlighted that use of antibiotics for colds/flu can select for antibiotic resistant bacteria, and thus, reduce the efficacy of antibiotic treatment if a bacterial infection occurs in the subsequent months. ADVERSE EFFECT GROUP: Participants in the side effect information group will receive information outlining the side effects that are commonly experienced by people/children on antibiotic medications. ACTIVE CONTROL GROUP: Please see section below on Comparator / control treatment After the intervention has been delivered participants will proceed to their appointment as usual. Once participants have returned to the waiting room after their/their child’s appointment, they will be asked to complete a brief post-consultation questionnaire.
Sponsors
University of Auckland - Research Office
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
-aged over 18 years -attending an appointment with a general practitioner at Balmoral Doctors for symptoms of infection related to a cold/flu OR attending an appointment for a child (aged 0-7 years) with symptoms of URTI related to a cold/flu
Exclusion criteria
Exclusion criteria: -attending an appointment with a general practitioner at Balmoral Doctors for reasons other than URTI symptoms related to a cold/flu -attending an appointment with a practice nurse at Balmoral Doctors -cannot read, write, or speak in English
Outcome results
None listed