Public Health Interventions to Improve Antimicrobial Resistance Awareness and Behavioural Change Associated with Antimicrobial Use: A Systematic Review Exploring the Use of Social Media

Abstract

Introduction: Over the years there have been several interventions targeted at the public to increase their knowledge and awareness about Antimicrobial Resistance (AMR). In this work, we updated a previously published review by Price et al. (2018), on effectiveness of interventions to improve the public’s antimicrobial resistance awareness and behaviours associated with prudent use of antimicrobials to identify which interventions work best in influencing public behaviour. Methods: Five databases—Medline (OVID), CINAHL (EBSCO), Embase, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL-OVID)—were searched for AMR interventions between 2017 and 2021 targeting the public. All studies which had a before and after assessment of the intervention were considered for inclusion. Results: In total, 17 studies were found to be eligible for inclusion in the review. Since there was a variety in the study interventions and in particular outcomes, a narrative synthesis approach was adopted for analysis. Whereas each study showed some impact on awareness and knowledge, none measured long-term impact on behaviours towards antibiotic use, awareness, or knowledge. Engagement was higher in interventions which included interactive elements such as games or videos. Social media was not used for recruitment of participants or as a mode of communication in any AMR interventions included in this review.

Disease-Specific Quality Indicators for Outpatient Antibiotic Prescribing for Respiratory Infections (ESAC Quality Indicators) Applied to Point Prevalence Audit Surveys in General Practices in 13 European Countries

“…Interventions targeted at GP have shown successes and updates or adjustments to focus these campaigns in the light of our findings may be timely [ 27 , 28 , 29 ]. A recent review of public awareness campaigns on antibiotic prescribing and awareness highlighted that outcome measures to evaluate these campaigns differ widely, and no long-term outcomes (beyond 6 months) were included [ 30 ]. Additionally, it showed that social media was not used as a tool to increase public awareness, which may offer opportunities.…”

Knowledge, Attitudes and Practices of Parents and Pediatricians Regarding Antibiotic Use among Children: Differences in Relation to the Level of Education of the Parents in the Republic of Srpska Bosnia and Herzegovina

“…Despite the fact that the majority of similar studies have reported pediatricians as the preferred source of information, such as studies conducted in Cyprus [ 19 ] and Palestine [ 34 ], a study in China conducted by Xiang et al [ 35 ] identified television as the main source of information regarding the use or misuse of antibiotics. Studies have shown that education about the rational use of antibiotics is useful in increasing knowledge, but that they have very little effect in changing the attitudes and practices of the public towards the use of antibiotics [ 36 , 37 ]. Different types of interventions aimed at the rational use of antibiotics (educational interventions, theatrical and musical interventions, gamification, animated film, fear-based messages highlighting the side effects of antibiotic use, digital interventions), which until now have been used in the world and mostly target the public, have produced modest results [ 36 ].…”

“…Studies have shown that education about the rational use of antibiotics is useful in increasing knowledge, but that they have very little effect in changing the attitudes and practices of the public towards the use of antibiotics [ 36 , 37 ]. Different types of interventions aimed at the rational use of antibiotics (educational interventions, theatrical and musical interventions, gamification, animated film, fear-based messages highlighting the side effects of antibiotic use, digital interventions), which until now have been used in the world and mostly target the public, have produced modest results [ 36 ]. A study examining the impact of a television campaign on antibiotic use indicated that it was wrong to emphasize that the antibiotic user was responsible for the development of resistance because it was interpreted as childish by viewers.…”

Health Information Orientation Profiles and Their Association with Knowledge of Antibiotic Use in a Population with Good Internet Access: A Cross-Sectional Study

“…Hence, there is a need for deeper and more extensive social outreach to actively disseminate health information, for example on appropriate antibiotic use and AMR, to these sub-populations, as they are less likely to present themselves to a healthcare facility or have interest to actively seek out health information. Contemporary communication channels such as social media posts by trusted healthcare providers, with interactive games and videos embedded could be considered to provide health information to this sub-population with LL-HIO [ 35 ].…”