Please use this identifier to cite or link to this item: https://doi.org/10.1128/AAC.02257-16
Title: Results from a Patient-Based Health Education Intervention in Reducing Antibiotic Use for Acute Upper Respiratory Tract Infections in the Private Sector Primary Care Setting in Singapore
Authors: Lee, Magdalene Hui Min
Pan, Darius Shaw Teng
Huang, Joyce Huixin
Chen I-Cheng Mark 
CHONG WEN CHEN, JOASH 
GOH EE HUI 
JIANG LILI 
LEO YEE SIN 
Lee, Tau Hong
WONG CHIA SIONG 
LOH WENG KEONG VICTOR 
Lim Fong Seng 
Poh, Adrian Zhongxian
THAM TAT YEAN 
WONG WEI MON 
Yu, Yue
Keywords: Science & Technology
Life Sciences & Biomedicine
Microbiology
Pharmacology & Pharmacy
upper respiratory tract infection
intervention
antibiotics
antimicrobial stewardship
ANTIMICROBIAL RESISTANCE
PHYSICIANS
COMMUNITY
KNOWLEDGE
CHILDREN
ILLNESS
COHORT
ADULTS
TRIAL
Issue Date: 1-May-2017
Publisher: AMER SOC MICROBIOLOGY
Citation: Lee, Magdalene Hui Min, Pan, Darius Shaw Teng, Huang, Joyce Huixin, Chen I-Cheng Mark, CHONG WEN CHEN, JOASH, GOH EE HUI, JIANG LILI, LEO YEE SIN, Lee, Tau Hong, WONG CHIA SIONG, LOH WENG KEONG VICTOR, Lim Fong Seng, Poh, Adrian Zhongxian, THAM TAT YEAN, WONG WEI MON, Yu, Yue (2017-05-01). Results from a Patient-Based Health Education Intervention in Reducing Antibiotic Use for Acute Upper Respiratory Tract Infections in the Private Sector Primary Care Setting in Singapore. ANTIMICROBIAL AGENTS AND CHEMOTHERAPY 61 (5). ScholarBank@NUS Repository. https://doi.org/10.1128/AAC.02257-16
Abstract: Copyright © 2017 Lee et al. We investigated the efficacy of patient-targeted education in reducing antibiotic prescriptions for upper respiratory tract infections (URTIs) among adults in the private primary care setting in Singapore. Our randomized controlled trial enrolled patients aged 21 years and above presenting at general practitioner (GP) clinics with URTI symptoms for 7 days or less. Intervention arm patients were verbally educated via pamphlets about the etiology of URTIs, the role of antibiotics in treating URTIs, and the consequences of inappropriate antibiotic use. Control arm patients were educated on influenza vaccinations. Both arms were compared regarding the proportions prescribed antibiotics and the patients' postconsultation views. A total of 914 patients consulting 35 doctors from 24 clinics completed the study (457 in each arm). The demographics of patients in both arms were similar, and 19.1% were prescribed an antibiotic, but this varied from 0% to 70% for individual GPs. The intervention did not significantly reduce antibiotic prescriptions (odds ratio [OR], 1.20; 95% confidence interval [CI], 0.83-1.73) except in patients of Indian ethnicity (OR, 0.28; 95% CI, 0.09-0.93). Positive associations between the intervention and the view that antibiotics were not needed most of the time for URTIs (P = 0.047) and on being worried about the side effects of antibiotics (P = 0.018) were restricted to the Indian subgroup. GPs in limited liability partnerships or clinic chains prescribed less (OR, 0.36; 95% CI, 0.14 to 0.92), while certain inappropriate patient responses were associated with the receipt of antibiotics. Follow-up studies to investigate differences in responses to educational programs between ethnicities and to explore GP-targeted interventions are recommended.
Source Title: ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
URI: https://scholarbank.nus.edu.sg/handle/10635/162771
ISSN: 0066-4804
1098-6596
DOI: 10.1128/AAC.02257-16
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