Communication interventions to promote the public's awareness of antibiotics: A systematic review

Valerie R. Burstein, Renee P. Trajano, Richard L Kravitz, Robert A Bell, Darshan Vora, Larissa S May

Research output: Contribution to journalReview article

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.

Original languageEnglish (US)
Article number899
JournalBMC Public Health
Volume19
Issue number1
DOIs
StatePublished - Jul 8 2019

Fingerprint

Communication
Anti-Bacterial Agents
Microbial Drug Resistance
Education
Prescriptions
Ambulatory Care Facilities
Streptococcus pneumoniae
PubMed
Respiratory Tract Infections
Outpatients
Research Personnel
Morbidity
Physicians
Mortality

Keywords

  • Antibiotics
  • Messaging programs
  • Public awareness

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Communication interventions to promote the public's awareness of antibiotics : A systematic review. / Burstein, Valerie R.; Trajano, Renee P.; Kravitz, Richard L; Bell, Robert A; Vora, Darshan; May, Larissa S.

In: BMC Public Health, Vol. 19, No. 1, 899, 08.07.2019.

Research output: Contribution to journalReview article

Burstein, Valerie R. ; Trajano, Renee P. ; Kravitz, Richard L ; Bell, Robert A ; Vora, Darshan ; May, Larissa S. / Communication interventions to promote the public's awareness of antibiotics : A systematic review. In: BMC Public Health. 2019 ; Vol. 19, No. 1.
@article{bd2e1848265649828db34c5e4b2978ff,
title = "Communication interventions to promote the public's awareness of antibiotics: A systematic review",
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.",
keywords = "Antibiotics, Messaging programs, Public awareness",
author = "Burstein, {Valerie R.} and Trajano, {Renee P.} and Kravitz, {Richard L} and Bell, {Robert A} and Darshan Vora and May, {Larissa S}",
year = "2019",
month = "7",
day = "8",
doi = "10.1186/s12889-019-7258-3",
language = "English (US)",
volume = "19",
journal = "BMC Public Health",
issn = "1471-2458",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Communication interventions to promote the public's awareness of antibiotics

T2 - 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

PY - 2019/7/8

Y1 - 2019/7/8

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.

AB - 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.

KW - Antibiotics

KW - Messaging programs

KW - Public awareness

UR - http://www.scopus.com/inward/record.url?scp=85069052391&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85069052391&partnerID=8YFLogxK

U2 - 10.1186/s12889-019-7258-3

DO - 10.1186/s12889-019-7258-3

M3 - Review article

C2 - 31286948

AN - SCOPUS:85069052391

VL - 19

JO - BMC Public Health

JF - BMC Public Health

SN - 1471-2458

IS - 1

M1 - 899

ER -