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Communication interventions to promote the public's awareness of antibiotics: a systematic review.
BMC Public Health. 2019 Jul 08; 19(1):899.BP

Abstract

BACKGROUND

Inappropriate antibiotic use is implicated in antibiotic resistance and resultant morbidity and mortality. Overuse is particularly prevalent for outpatient respiratory infections, and perceived patient expectations likely contribute. Thus, various educational programs have been implemented to educate the public.

METHODS

We systematically identified public-directed interventions to promote antibiotic awareness in the United States. PubMed, Google Scholar, Embase, CINAHL, and Scopus were queried for articles published from January 1996 through January 2016. Two investigators independently assessed titles and abstracts of retrieved articles for subsequent full-text review. References of selected articles and three review articles were likewise screened for inclusion. Identified educational interventions were coded for target audience, content, distribution site, communication method, and major outcomes.

RESULTS

Our search yielded 1,106 articles; 34 met inclusion criteria. Due to overlap in interventions studied, 29 distinct educational interventions were identified. Messages were primarily delivered in outpatient clinics (N = 24, 83%) and community sites (N = 12, 41%). The majority included clinician education. Antibiotic prescription rates were assessed for 22 interventions (76%). Patient knowledge, attitudes, and beliefs (KAB) were assessed for 10 interventions (34%). Similar rates of success between antibiotic prescription rates and patient KAB were reported (73 and 70%, respectively). Patient interventions that did not include clinician education were successful to increase KAB but were not shown to decrease antibiotic prescribing. Three interventions targeted reductions in Streptococcus pneumoniae resistance; none were successful.

CONCLUSIONS

Messaging programs varied in their designs, and many were multifaceted in their approach. These interventions can change patient perspectives regarding antibiotic use, though it is unclear if clinician education is also necessary to reduce antibiotic prescribing. Further investigations are needed to determine the relative influence of interventions focusing on patients and physicians and to determine whether these changes can influence rates of antibiotic resistance long-term.

Authors+Show Affiliations

Ohio State University College of Medicine, Columbus, OH, USA. valerie.burstein@osumc.edu.University of California Davis, Davis, CA, USA.University of California Davis, Sacramento, CA, USA.University of California Davis, Davis, CA, USA.The George Washington University School of Medicine & Health Sciences, Washington, DC, USA.University of California Davis, Sacramento, CA, USA.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

31286948

Citation

Burstein, Valerie R., et al. "Communication Interventions to Promote the Public's Awareness of Antibiotics: a Systematic Review." BMC Public Health, vol. 19, no. 1, 2019, p. 899.
Burstein VR, Trajano RP, Kravitz RL, et al. Communication interventions to promote the public's awareness of antibiotics: a systematic review. BMC Public Health. 2019;19(1):899.
Burstein, V. R., Trajano, R. P., Kravitz, R. L., Bell, R. A., Vora, D., & May, L. S. (2019). Communication interventions to promote the public's awareness of antibiotics: a systematic review. BMC Public Health, 19(1), 899. https://doi.org/10.1186/s12889-019-7258-3
Burstein VR, et al. Communication Interventions to Promote the Public's Awareness of Antibiotics: a Systematic Review. BMC Public Health. 2019 Jul 8;19(1):899. PubMed PMID: 31286948.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Communication interventions to promote the public's awareness of antibiotics: a systematic review. AU - Burstein,Valerie R, AU - Trajano,Renee P, AU - Kravitz,Richard L, AU - Bell,Robert A, AU - Vora,Darshan, AU - May,Larissa S, Y1 - 2019/07/08/ PY - 2019/03/17/received PY - 2019/06/28/accepted PY - 2019/7/10/entrez PY - 2019/7/10/pubmed PY - 2019/10/11/medline KW - Antibiotics KW - Messaging programs KW - Public awareness SP - 899 EP - 899 JF - BMC public health JO - BMC Public Health VL - 19 IS - 1 N2 - BACKGROUND: Inappropriate antibiotic use is implicated in antibiotic resistance and resultant morbidity and mortality. Overuse is particularly prevalent for outpatient respiratory infections, and perceived patient expectations likely contribute. Thus, various educational programs have been implemented to educate the public. METHODS: We systematically identified public-directed interventions to promote antibiotic awareness in the United States. PubMed, Google Scholar, Embase, CINAHL, and Scopus were queried for articles published from January 1996 through January 2016. Two investigators independently assessed titles and abstracts of retrieved articles for subsequent full-text review. References of selected articles and three review articles were likewise screened for inclusion. Identified educational interventions were coded for target audience, content, distribution site, communication method, and major outcomes. RESULTS: Our search yielded 1,106 articles; 34 met inclusion criteria. Due to overlap in interventions studied, 29 distinct educational interventions were identified. Messages were primarily delivered in outpatient clinics (N = 24, 83%) and community sites (N = 12, 41%). The majority included clinician education. Antibiotic prescription rates were assessed for 22 interventions (76%). Patient knowledge, attitudes, and beliefs (KAB) were assessed for 10 interventions (34%). Similar rates of success between antibiotic prescription rates and patient KAB were reported (73 and 70%, respectively). Patient interventions that did not include clinician education were successful to increase KAB but were not shown to decrease antibiotic prescribing. Three interventions targeted reductions in Streptococcus pneumoniae resistance; none were successful. CONCLUSIONS: Messaging programs varied in their designs, and many were multifaceted in their approach. These interventions can change patient perspectives regarding antibiotic use, though it is unclear if clinician education is also necessary to reduce antibiotic prescribing. Further investigations are needed to determine the relative influence of interventions focusing on patients and physicians and to determine whether these changes can influence rates of antibiotic resistance long-term. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/31286948/Communication_interventions_to_promote_the_public's_awareness_of_antibiotics:_a_systematic_review_ L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7258-3 DB - PRIME DP - Unbound Medicine ER -