Abstract
The misuse of antibiotics is a worldwide public health concern. Behavioral Intervention programs that aim to reduce patients’ own request for antibiotics during their visit to primary care clinics is an attractive strategy to combat this problem. We tested the effectiveness of a behavioral modification method known as the Tailoring Antimicrobial resistance Programs (TAP) in reducing the request for antibiotics by patients visiting primary care clinics for mild upper respiratory tract infections (URTIs). A stratified cluster randomized design with two groups pre-post, comparing intervention with the control, was conducted in six health centers. TAP was implemented for eight weeks. Request for antibiotics was assessed before (period 1) and after introducing TAP (period 2). The percentage of patients or their escorts who requested antibiotics in period 1 was 59.7% in the control group and 60.2% in the intervention group. The percentage of patients who requested antibiotics did not significantly change between period 1 and 2 in the control group, who continued to receive the standard of care. The above percentage significantly decreased in the intervention group from 60.2% to 38.5% (p < 0.05). We conclude that behavioral change programs including TAP are a viable alternative strategy to address antibiotic misuse in Jordan.
Highlights
Antimicrobial resistance is a threat to the public health sector worldwide [1]
It is interesting to note that most of the unnecessary antibiotic prescription takes place in the primary care setting [6], with the biggest percentage of unnecessary antibiotics being prescribed for patients with upper respiratory tract infections (URTIs) [6]
In period 1, there was a pre-assessment of antibiotic request
Summary
Antimicrobial resistance is a threat to the public health sector worldwide [1]. Many factors contribute to this problem; the misuse and/or overuse of antibiotics are established as the major driving forces [2,3]. It was estimated that up to 50% of all antimicrobials globally prescribed to patients are not even necessary [4,5]. It is interesting to note that most of the unnecessary antibiotic prescription takes place in the primary care setting [6], with the biggest percentage of unnecessary antibiotics being prescribed for patients with upper respiratory tract infections (URTIs) [6]. The misuse of antibiotics by consumers, including the use of antibiotics without prescriptions, was widely documented in Jordan and in the region [7,8,9,10,11,12]. Other forms of antibiotic misuse in the MENA region include the use of antibiotics for improper indications, including to fight viral infections [13,14,15,16]
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