Knowledge, attitudes and practices regarding antimicrobial use and resistance among healthcare seekers in two tertiary hospitals in Ghana: a quasi experimental study
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Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Open
Abstract
Objective 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.
Design 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.
Setting Korle-Bu and Komfo Anokye Teaching Hospitals,
Ghana.
Participants Adult patients aged 18 years and older
seeking outpatient care.
Main outcome measures 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.
Results 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).
Conclusion 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.
Description
Research Article
Keywords
Knowledge, attitudes, practices, antimicrobial use, Ghana
Citation
To cite: Otieku E, Fenny AP, Labi A-K, et al. Knowledge, attitudes and practices regarding antimicrobial use and resistance among healthcare seekers in two tertiary hospitals in Ghana: a quasi experimental study. BMJ Open 2023;13:e065233. doi:10.1136/ bmjopen-2022-065233