Exploring community healthcare providers’ perceptions on antimicrobial resistance

Ellen, Moriah; Shach, Ruth; Perlman, Saritte

doi:10.1016/j.jgar.2019.02.010

Cited by 4 publications

(3 citation statements)

References 32 publications

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“…The fear of patient deterioration or complications was the foremost reason (34% of respondents), both in primary and secondary care settings, for issuing an antibiotic prescription, and uncertainty in diagnosis was the second most common reason (25%). These findings correlate with the literature; fear has been cited as a common barrier to tackling AMR amongst community healthcare providers and physicians, alongside patient pressure, time and systemic overworking [ 12 , 13 , 25 , 26 ].…”

Section: Discussionsupporting

confidence: 85%

Knowledge and Attitudes about Antibiotics and Antibiotic Resistance of 2404 UK Healthcare Workers

Ashiru‐Oredope¹,

Casale²,

Harvey³

et al. 2022

Antibiotics

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Background: Using the COM-B model as a framework, an EU-wide survey aimed to ascertain multidisciplinary healthcare workers’ (HCWs’) knowledge, attitudes and behaviours towards antibiotics, antibiotic use and antibiotic resistance. The UK findings are presented here. Methods: A 43-item questionnaire was developed through a two-round modified Delphi consensus process. The UK target quota was 1315 respondents. Results: In total, 2404 participants responded. The highest proportion were nursing and midwifery professionals (42%), pharmacists (23%) and medical doctors (18%). HCWs correctly answered that antibiotics are not effective against viruses (97%), they have associated side effects (97%), unnecessary use makes antibiotics ineffective (97%) and healthy people can carry antibiotic-resistant bacteria (90%). However, fewer than 80% correctly answered that using antibiotics increases a patient’s risk of antimicrobial resistant infection or that resistant bacteria can spread from person to person. Whilst the majority of HCWs (81%) agreed there is a connection between their antibiotic prescribing behaviour and the spread of antibiotic-resistant bacteria, only 64% felt that they have a key role in controlling antibiotic resistance. The top three barriers to providing advice or resources were lack of resources (19%), insufficient time (11%) and the patient being uninterested in the information (7%). Approximately 35% of UK respondents who were prescribers prescribed an antibiotic at least once in the previous week to responding to the survey due to a fear of patient deterioration or complications. Conclusion: These findings highlight that a multifaceted approach to tackling the barriers to prudent antibiotic use in the UK is required and provides evidence for guiding targeted policy, intervention development and future research. Education and training should focus on patient communication, information on spreading resistant bacteria and increased risk for individuals.

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Section: Discussionsupporting

confidence: 85%

Knowledge and Attitudes about Antibiotics and Antibiotic Resistance of 2404 UK Healthcare Workers

Ashiru‐Oredope¹,

Casale²,

Harvey³

et al. 2022

Antibiotics

View full text Add to dashboard Cite

show abstract

“…This situation leads veterinarians to feel frustrated and stigmatized, which may contribute to redirection to other antimicrobial prescribers and users, such as farmers, small-animal practitioners, and human doctors and patients for inappropriate AMU and AMR. Dairy farmers from the same region manifested similar other-blaming attitudes in our previous qualitative study [21] and the same phenomenon has been reported in poultry veterinarians and human medicine [39,40]. In our work, dairy farmers and veterinarians expressed the perception that they did not use more antimicrobials than necessary to meet their wish and duty to support animal health and welfare.…”

Section: Discussionsupporting

confidence: 84%

Understanding the role of veterinarians in antimicrobial stewardship on Canadian dairy farms: A mixed-methods study

Cobo-Ángel¹,

Roche²,

LeBlanc³

2023

PLoS ONE

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The aim of this study was to describe the factors that influence dairy cattle veterinarians´ antimicrobial prescribing, their attitudes toward reducing antimicrobial use (AMU) in the dairy industry, awareness of antimicrobial resistance (AMR), and perceived barriers to improving antimicrobial stewardship (AMS) on Canadian dairy farms. We used quantitative and qualitative research methods to consider the complexity of the antimicrobial prescription decision-making process. We designed and distributed an online survey, followed by four online focus groups with practicing veterinarians. We used frequency tables and unconditional associations to analyze quantitative data, and thematic analysis to analyze qualitative data. In total, 107 participants from four Canadian provinces responded to the survey, and 26 veterinarians participated in the focus groups. Results from both studies were triangulated to draw our key findings. We found that 1) Veterinarians must weigh numerous intra-personal and contextual considerations that could be conflicting in their decision-making process for prescribing antimicrobials. 2) Although less experienced veterinarians showed greater awareness of AMR and motivation to improve AMS than more experienced veterinarians, they also reported feeling more pressure to adapt their prescribing practices to farmers’ wishes than more experienced veterinarians. 3) Some veterinarians experienced conflict between prescribing antimicrobials to maintain animal health, productivity, and welfare, and AMS, which could result in blaming others for inappropriate antimicrobial use and reducing the opportunity to critically review their own prescribing practices. 4) There were strategies and barriers in common between veterinarians and farmers such as collaborative reviews of disease treatment protocols and improving preventive medicine on dairy farms. 5) The main barriers to reducing AMU on dairy farms reported by veterinarians were concerns about animal welfare and AMU on dairy farms without consultation with the veterinarian. Our results can inform the development of AMS programs in the Canadian dairy industry.

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“…The fear of patient deterioration or complications was the foremost reason (34% of respondents), both in primary and secondary care settings, for issuing an antibiotic prescription, and uncertainty in diagnosis was the second commonest reason (25%). Fear was also found to be a barrier to tackling MR amongst community healthcare providers, alongside physician pressures and systemic overworking [20].…”

Section: Discussionmentioning

confidence: 99%

Knowledge and Attitudes about Antibiotics and Antibiotic Resistance of 2,404 UK Healthcare Workers

Ashiru‐Oredope¹,

Casale²,

Harvey³

et al. 2022

Preprint

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Background: Using the COM-B model as a framework, an EU-wide survey aimed to ascertain multidisciplinary healthcare workers’ (HCWs) knowledge, attitudes and behaviours on antibiotics, antibiotic use and antibiotic resistance. The UK findings are presented. Methods: A 43-item questionnaire was developed through a two-round modified Delphi consensus process. The UK target quota was 1,315 respondents. Results: 2,404 participants responded. The highest proportion were nursing and midwifery professionals (42%), pharmacists (23%) and medical doctors (18%). HCWs correctly answered that antibiotics are not effective against viruses (97%), they have associated side effects (97%), unnecessary use makes antibiotics ineffective (97%) and healthy people can carry antibiotic resistant bacteria (90%). However, fewer than 80% correctly answered that using antibiotics increases a patient’s risk of antimicrobial resistant infection or that resistant bacteria can spread from person to person. Whilst the majority of HCWs (81%) agreed there is a connection between their antibiotic prescribing behaviour and the spread of antibiotic resistant bacteria, only 64% felt that they have a key role in controlling antibiotic resistance. The top three barriers to providing advice or resources were lack of resources (19%), insufficient time (11%) and the patient being uninterested in the information (7%). Approximately 35% of UK respondents who were prescribers prescribed an antibiotic at least once in the last week due to fear of patient deterioration or complications. Conclusion: These findings highlight that a multifaceted approach to tackling the barriers to prudent antibiotic use in the UK is required and provides evidence for guiding targeted policy, intervention development and future research. Education and training should focus on patient communication, information on spreading resistant bacteria and increased risk for individuals.

show abstract

Exploring community healthcare providers’ perceptions on antimicrobial resistance

Cited by 4 publications

References 32 publications

Knowledge and Attitudes about Antibiotics and Antibiotic Resistance of 2404 UK Healthcare Workers

Knowledge and Attitudes about Antibiotics and Antibiotic Resistance of 2404 UK Healthcare Workers

Understanding the role of veterinarians in antimicrobial stewardship on Canadian dairy farms: A mixed-methods study

Knowledge and Attitudes about Antibiotics and Antibiotic Resistance of 2,404 UK Healthcare Workers

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