V Zanichelli1, G Tebano2, I C Gyssens3, V Vlahović-Palčevski4, A A Monnier5, M Stanic Benic6, S Harbarth7, M Hulscher8, C Pulcini9, B D Huttner7. 1. Infection Control Program, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland. Electronic address: veronica.zanichelli.it@gmail.com. 2. Université de Lorraine, EA 4360 APEMAC, Nancy, France. 3. Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands; Faculty of Medicine, Research Group of Immunology and Biochemistry, Hasselt University, Hasselt, Belgium. 4. Department of Clinical Pharmacology, University Hospital Rijeka, Rijeka, Croatia; University of Rijeka, Medical Faculty, Rijeka, Croatia. 5. Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands; Faculty of Medicine, Research Group of Immunology and Biochemistry, Hasselt University, Hasselt, Belgium; Scientific Centre for Quality of Healthcare (IQ Healthcare), Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands. 6. Department of Clinical Pharmacology, University Hospital Rijeka, Rijeka, Croatia. 7. Infection Control Program, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland; Division of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland. 8. Scientific Centre for Quality of Healthcare (IQ Healthcare), Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands. 9. Université de Lorraine, EA 4360 APEMAC, Nancy, France; CHRU de Nancy, Service de Maladies Infectieuses et Tropicales, Nancy, France.
Abstract
OBJECTIVES: We aimed to assess patient-related determinants potentially influencing antibiotic use. METHODS: Studies published in MEDLINE until 30 September 2015 were searched. We included: qualitative studies describing patients' self-reported determinants of antibiotic use; and quantitative studies on either self-reported or objectively assessed determinants associated with antibiotic use. Whenever possible, reported determinants were categorized as 'barriers' or 'facilitators' of responsible antibiotic use. RESULTS: A total of 87 studies from 33 countries were included. Seventy-five (86.2%) were quantitative and described self-reported (45/75, 60.0%), objectively assessed (20/75, 26.7%) or self-reported and objectively assessed (10/75, 13.3%) patient-related determinants. Twelve (12/87, 13.8%) were qualitative studies or had a qualitative and quantitative component. Eighty-six of the studies (98.8%) concerned the outpatient setting. We identified seven broad categories of determinants having an impact on different aspects of antibiotic use (in descending order of frequency): demographic and socio-economic characteristics, patient-doctor interactions (e.g. counselling), treatment characteristics (e.g. administration frequency), attitudes (e.g. expecting antibiotics), access to treatment (e.g. patients' direct costs), characteristics of the condition for which the antibiotic was prescribed (e.g. duration of symptoms), knowledge (e.g. regarding indications for treatment). Most determinants were classified as 'barriers' to responsible antibiotic use. CONCLUSION: A large variety of patient-related determinants impact antibiotic use. The most easily 'modifiable' determinants concern patient-doctor interactions, treatment characteristics and knowledge. Data from the inpatient setting and low- and middle-income countries were underrepresented. Further studies should develop and test interventions that take these determinants into account with the ultimate aim of improving responsible use of antibiotics.
OBJECTIVES: We aimed to assess patient-related determinants potentially influencing antibiotic use. METHODS: Studies published in MEDLINE until 30 September 2015 were searched. We included: qualitative studies describing patients' self-reported determinants of antibiotic use; and quantitative studies on either self-reported or objectively assessed determinants associated with antibiotic use. Whenever possible, reported determinants were categorized as 'barriers' or 'facilitators' of responsible antibiotic use. RESULTS: A total of 87 studies from 33 countries were included. Seventy-five (86.2%) were quantitative and described self-reported (45/75, 60.0%), objectively assessed (20/75, 26.7%) or self-reported and objectively assessed (10/75, 13.3%) patient-related determinants. Twelve (12/87, 13.8%) were qualitative studies or had a qualitative and quantitative component. Eighty-six of the studies (98.8%) concerned the outpatient setting. We identified seven broad categories of determinants having an impact on different aspects of antibiotic use (in descending order of frequency): demographic and socio-economic characteristics, patient-doctor interactions (e.g. counselling), treatment characteristics (e.g. administration frequency), attitudes (e.g. expecting antibiotics), access to treatment (e.g. patients' direct costs), characteristics of the condition for which the antibiotic was prescribed (e.g. duration of symptoms), knowledge (e.g. regarding indications for treatment). Most determinants were classified as 'barriers' to responsible antibiotic use. CONCLUSION: A large variety of patient-related determinants impact antibiotic use. The most easily 'modifiable' determinants concern patient-doctor interactions, treatment characteristics and knowledge. Data from the inpatient setting and low- and middle-income countries were underrepresented. Further studies should develop and test interventions that take these determinants into account with the ultimate aim of improving responsible use of antibiotics.
Authors: Alike W van der Velden; Aurelio Sessa; Attila Altiner; Antonio Carlos Campos Pignatari; Adrian Shephard Journal: Pragmat Obs Res Date: 2020-09-10
Authors: Irene Anna Lambraki; Melanie Cousins; Tiscar Graells; Anaïs Léger; Patrik Henriksson; Stephan Harbarth; Max Troell; Didier Wernli; Peter Søgaard Jørgensen; Andrew P Desbois; Carolee A Carson; Elizabeth Jane Parmley; Shannon Elizabeth Majowicz Journal: PLoS One Date: 2022-02-22 Impact factor: 3.240