Abstract
Educational interventions targeting health care professionals can contribute to improving knowledge and behaviors of antimicrobial agents prescribing. However, the unprecedented COVID-19 outbreak caused a disruption of the current practices and treatment guidelines. Therefore, it is highly likely that the pandemic had its disruptive effect on any educational interventions that were going on during the outbreak. This study aims to evaluate the effectiveness of an educational intervention in improving antimicrobial agents prescribing. This was a randomized controlled study that included 69 resident physicians in a teaching hospital. The intervention group received an educational intervention focusing on antimicrobial agents prescribing and resistance. Before and after the intervention, outpatient antimicrobial agents prescribing rates for the two study arms were compared for the pre- and post-intervention periods. Additionally, all participants were asked to complete an online questionnaire that measured their knowledge, attitudes and behavioral intention towards antimicrobial agents resistance and prescription. The post-intervention period included the months of February, March, and June 2020. April and May were excluded from the study period since clinics were closed due to the COVID -19 pandemic. Post-intervention, the rate of antimicrobial agents prescribing by the intervention group was significantly higher than that of the control group (p < 0.001). Mean fear score for the intervention group was significantly lower than that for the control group after the intervention. Findings indicate failure of the educational intervention in improving antimicrobial agents prescribing. However, an unexpected counter effect of the COVID-19 outbreak is highly likely.
Highlights
Educational interventions targeting health care professionals can contribute to improving knowledge and behaviors of antimicrobial agents prescribing
The seminars discussed the approach to antimicrobial agents prescribing and dispensing according to the Centor criteria used in Jordan University Hospital [16], the American Family Physician guidelines for use of antimicrobial agents in acute upper respiratory tract infections (URTI) [17], and the National Institute for Health and Clinical Excellence’s (NICE) care pathway for respiratory tract infections [18]
No significant differences in mean attitude, behavioral intention, and knowledge scores existed at baseline between the intervention and control groups (Table 3)
Summary
Educational interventions targeting health care professionals can contribute to improving knowledge and behaviors of antimicrobial agents prescribing. Several bacterial infections including lower respiratory tract infections are still listed among the most common causes of death according to the World Health Organization (WHO) [2]. Such predicament could be mainly attributed to the antimicrobial resistance crisis, which threatens a transition to an era where antimicrobial agents are no longer effective [1]. One of the major factors playing a role in developing antimicrobial resistance is inappropriate prescribing behavior [4] This can be manifested in several aspects including uncertainty of diagnosis, patients’ persistence on receiving antimicrobial agents, inadequate prescribing guidelines, avoidance of possible complications arising in patients, and ignorance of prescribing behavior as being a cause of antimicrobial agents resistance [5,6]. It has been found that patients influence physicians’ prescribing behavior through increased pressure and possibility of changing physicians if no antimicrobial agents prescription was provided [5,9]
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