Elsevier

Public Health

Volume 151, October 2017, Pages 146-148
Public Health

Short Communication
Gambling with antibiotics: a novel approach for exploring antibiotic consumption decision-making

https://doi.org/10.1016/j.puhe.2017.07.012Get rights and content

Highlights

  • Standard gamble approach is used to explore the propensity for wanting antibiotics.

  • The public seem more reluctant to want antibiotics when effectiveness is reduced.

  • Mention of negative community impact did appear to alter public decision-making.

  • Future work should utilise representative samples and hypothesis testing techniques.

Introduction

Antimicrobial resistance (AMR) is a global health issue, with resistant microbes causing a threat to many branches of medical care.1 It has been estimated that, if resistance continues to increase, AMR could lead to 10 million excess deaths annually by 2050.1 Drivers of AMR are thought to include antimicrobial misuse and overuse in animals and humans.1, 2 Recent policy recommendations aim to reduce inappropriate antibiotic usage to tackle this issue.3

Recent international campaigns have highlighted the importance of ‘protecting antibiotics’, encouraging healthcare professionals and the public to reduce unnecessary use.4 For such policy to be effective, the public's (i) knowledge of inappropriate antibiotic usage, (ii) knowledge of AMR and its consequences and (iii) willingness to change behaviour when presented with additional information must be better understood.

Recent research has highlighted a general lack of public AMR knowledge in terms of its current and potential clinical impact, whilst also suggesting that perceived antibiotic effectiveness influences public decision-making.5 This research has also highlighted that engaging the public by personalising the context within which decisions are made has a greater impact in terms of the message ‘hitting home’.5

Building on this work, the current study aimed to pilot a novel way to determine the propensity of individuals to want to take antibiotics in response to a ‘flu-like illness’. This ‘want’ was investigated in a number of scenarios, capturing the influence of (i) levels of ‘effectiveness’ of antibiotics and (ii) provision of information about the community impact of personal antibiotic use. This article highlights the use of a novel methodology, and how this could be improved for future use.

Section snippets

Gambling with antibiotics

Standard gamble (SG) is an approach which aims to obtain a preference weight (a number between 0 and 1) for being in a health state. The approach will typically present two scenarios: choice A in which the respondent has a particular condition for a stated period of time (e.g. blindness) and choice B in which the respondent has a gamble between perfect health and death (e.g. 90% chance of living in perfect health vs 10% chance of dying). The respondent is then asked which choice they prefer.

Public policy and future research

This study found that participants were receptive to the idea of their local ‘community’ being affected by AMR, and this generally affected their decision-making on antibiotic consumption. This suggests that providing the public with relevant AMR information on a more personal or local level, not just through general public awareness campaigns, could be beneficial (e.g. through their GP or local authority). This study does not attempt to disentangle all of the potential factors (e.g. impact on

Acknowledgements

The authors would like to thank Nina Zhu for helping in the development of the pilot of this study and Hannah Lishman for assisting with data collection.

Ethical approval

None sought. This project was reviewed by the regional ethics committee, who deemed that citizen interviews and festival involvement did not require ethical approval to proceed, being allowed to progress under the local clinical governance and research compliance office oversight.

Funding

The research was funded by the National Institute for Health

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c

Present address: National Institute of Health Research (NIHR) Diagnostic Evidence Co-operative (DEC) London which is at Imperial College London, St Mary's Hospital, Praed Street, London, W2 1NY, United Kingdom.

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