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Reducing the demand for antibiotic prescriptions: evidence from an online survey of the general public on the interaction between preferences, beliefs and information, United Kingdom, 2015

Abstract:

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. This study investigated what drives patient expectations for antibiotics for ILI; particularly whether AMR-awareness, or risk or time preference, plays a role. In 2015 a representative online panel survey of 2,064 United Kingdom based adults asked respondents about antibiotic usage and effectiveness for ILI. Explanatory variables in multivariable regression included AMR-awareness, risk and time preferences plus covariates. The tendency not to prioritise immediate gain over later reward was independently strongly associated with greater awareness that antibiotics are inappropriate for ILI. Independently, erroneous beliefs and low AMR-awareness significantly predicted reported antibiotic use. However, 272 (39%) of those with low AMR-awareness said 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). 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.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.2807/1560-7917.ES.2018.23.25.1700424

Authors

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Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
Population Health
Role:
Author
More by this author
Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
NDM; NDM Experimental Medicine
Role:
Author
More by this author
Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
Primary Care Health Sciences
Role:
Author
More by this author
Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
RDM; RDM Clinical Laboratory Sciences
Role:
Author
More by this author
Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
NDM; NDM Experimental Medicine
Role:
Author


Publisher:
European Centre for Disease Prevention and Control
Journal:
Eurosurveillance More from this journal
Volume:
23
Issue:
25
Pages:
=1700424
Publication date:
2018-06-21
Acceptance date:
2018-04-19
DOI:
EISSN:
1025-496X
ISSN:
1560-7917


Keywords:
Pubs id:
pubs:847697
UUID:
uuid:26519d84-e4ca-4c0e-a015-028dcb349a70
Local pid:
pubs:847697
Source identifiers:
847697
Deposit date:
2018-05-14
ARK identifier:

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