Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore.
BMC Public Health. 2023 Mar 20;23(1):532. doi: 10.1186/s12889-023-15184-y.
Public health strategies to improve patient adherence to antibiotics rely mostly on raising awareness of the threat of antimicrobial resistance (AMR) and improving knowledge about antibiotics. We aimed to evaluate how adherence to antibiotics relates to knowledge and the threat perceptions proposed by the Protection Motivation Theory (PMT).
A cross-sectional online survey was conducted in September-December 2020 with 1002 participants aged 21-70 years in Singapore. Two items, which were reverse coded, evaluated adherence to antibiotics: 'how often do you obtain antibiotics that were left over from the previous prescription' and 'how often did you treat yourself with antibiotics in the past year'. Questions about the PMT-related constructs, and knowledge regarding antibiotics and AMR knowledge were also included. Hierarchical regression models were performed at a 5% significance level.
Adherence to antibiotics was associated with knowledge level (β = 0.073, p < 0.05), education level (β = - 0.076, p < 0.01), and four of the five PMT constructs: "perceived response cost" (β = 0.61, p < 0.01), "perceived response efficacy of adherence to antibiotic" (β = 0.096, p < 0.01), "perceived susceptibility to AMR" (β = 0.097, p < 0.01), and "perceived severity of AMR" (β = - 0.069, p < 0.01). Knowledge about AMR, perceived self-efficacy in adhering to antibiotics, age, and sex were not associated with adherence.
In Singapore, patient adherence to antibiotics appear to be driven by the perceived costs of visiting a doctor to obtain antibiotics, followed by perceptions of AMR as a threat and to a lesser extent, knowledge about antibiotics. Public health strategies to mitigate antibiotic misuse should consider these patient barriers to medical care.
提高患者对抗生素的依从性的公共卫生策略主要依赖于提高对抗微生物药物耐药性（AMR）的威胁的认识，并提高对抗生素的了解。我们旨在评估对抗生素的依从性与保护动机理论（PMT）提出的知识和威胁感知之间的关系。
2020 年 9 月至 12 月，在新加坡对 1002 名 21-70 岁的参与者进行了横断面在线调查。有两个项目是反向编码的，用于评估抗生素的依从性：“您经常获得上次处方剩余的抗生素吗？”和“您在过去一年中是否经常用抗生素自行治疗？”还包括与 PMT 相关的结构，以及有关抗生素和 AMR 知识的问题。在 5%的显著性水平上进行了分层回归模型。
抗生素的依从性与知识水平（β=0.073，p<0.05），教育水平（β=-0.076，p<0.01）和 PMT 的五个结构中的四个有关：“感知的反应成本”（β=0.61，p<0.01），“对抗生素的依从性的感知反应效果”（β=0.096，p<0.01），“对抗生素的易感性”（β=0.097，p<0.01）和“对抗生素耐药性的严重性”（β=-0.069，p<0.01）。对 AMR 的了解，对抗生素的自我效能感，年龄和性别与依从性无关。
在新加坡，患者对抗生素的依从性似乎是由获得抗生素的就诊成本感知驱动的，其次是对 AMR 的威胁的感知，而对抗生素的了解则次之。减轻抗生素滥用的公共卫生策略应考虑到这些患者对医疗的障碍。
