Economics Division, Institute of Statistical, Social, and Economic Research (ISSER), University of Ghana, Legon, Ghana
Department of Public Health, Aarhus University, Aarhus, Denmark.
BMJ Open. 2023 Feb 22;13(2):e065233. doi: 10.1136/bmjopen-2022-065233.
To evaluate knowledge of antimicrobial resistance (AMR), to study how the judgement of health value (HVJ) and economic value (EVJ) affects antibiotic use, and to understand if access to information on AMR implications may influence perceived AMR mitigation strategies.
A quasi-experimental study with interviews performed before and after an intervention where hospital staff collected data and provided one group of participants with information about the health and economic implications of antibiotic use and resistance compared with a control group not receiving the intervention.
Korle-Bu and Komfo Anokye Teaching Hospitals, Ghana.
Adult patients aged 18 years and older seeking outpatient care.
We measured three outcomes: (1) level of knowledge of the health and economic implications of AMR; (2) HVJ and EVJ behaviours influencing antibiotic use and (3) differences in perceived AMR mitigation strategy between participants exposed and not exposed to the intervention.
Most participants had a general knowledge of the health and economic implications of antibiotic use and AMR. Nonetheless, a sizeable proportion disagreed or disagreed to some extent that AMR may lead to reduced productivity/indirect costs (71% (95% CI 66% to 76%)), increased provider costs (87% (95% CI 84% to 91%)) and costs for carers of AMR patients/societal costs (59% (95% CI 53% to 64%)). Both HVJ-driven and EVJ-driven behaviours influenced antibiotic use, but the latter was a better predictor (reliability coefficient >0.87). Compared with the unexposed group, participants exposed to the intervention were more likely to recommend restrictive access to antibiotics (p<0.01) and pay slightly more for a health treatment strategy to reduce their risk of AMR (p<0.01).
There is a knowledge gap about antibiotic use and the implications of AMR. Access to AMR information at the point of care could be a successful way to mitigate the prevalence and implications of AMR.
评估抗菌药物耐药性（AMR）相关知识，研究健康价值（HVJ）和经济价值（EVJ）判断如何影响抗生素使用，并了解获取 AMR 影响信息是否会影响感知到的 AMR 缓解策略。
一项准实验研究，在干预前后进行访谈，在此期间，医院工作人员收集数据，并为一组参与者提供有关抗生素使用和耐药相关健康和经济影响的信息，而对照组则未接受干预。
加纳科勒布和科姆福安诺耶教学医院。
年龄在 18 岁及以上、寻求门诊治疗的成年患者。
我们测量了三个结果：（1）AMR 的健康和经济影响的知识水平；（2）影响抗生素使用的 HVJ 和 EVJ 行为；（3）暴露于干预措施和未暴露于干预措施的参与者对 AMR 缓解策略的看法差异。
大多数参与者对抗生素使用和 AMR 的健康和经济影响有一般了解。尽管如此，相当一部分人不同意或在某种程度上不同意 AMR 可能导致生产力/间接成本降低（71%（95%CI 66%至 76%））、增加提供者成本（87%（95%CI 84%至 91%））和 AMR 患者护理者/社会成本（59%（95%CI 53%至 64%））。HVJ 驱动和 EVJ 驱动的行为都影响抗生素的使用，但后者是更好的预测因素（可靠性系数>0.87）。与未暴露组相比，暴露于干预组的参与者更有可能推荐限制抗生素的获取（p<0.01），并且更愿意为降低 AMR 风险的健康治疗策略支付略高的费用（p<0.01）。
关于抗生素使用和 AMR 影响的知识存在差距。在护理点获取 AMR 信息可能是减轻 AMR 流行和影响的一种成功方法。
