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General Public's Knowledge, Attitude and Practice Survey on Antimicrobial Resistance 2016/17

General Public's Knowledge, Attitude and Practice Survey on Antimicrobial Resistance 2016/17

General Public's Knowledge, Attitude and Practice Survey on Antimicrobial Resistance 2016/17

Introduction

The Department of Health commissioned a research centre to conduct a territory-wide telephone survey to gauge the general public’s awareness of Antimicrobial Resistance (“AMR”) problem; knowledge, attitude and practice on antibiotic use; and their views on potential control measures and AMR-related health promotion.

 

Research Methodology

The survey was an anonymous telephone survey. The target respondents were Cantonese, Putonghua or English-speaking non-institutional Hong Kong residents (excluding foreign domestic helpers) aged 15 or above. A bilingual (Chinese and English) questionnaire was used to collect data. Fieldwork took place between 23 December 2016 and 19 January 2017. In total, 1,255 eligible respondents completed the interview. The response rate was 10.8%.

 

Key findings

  • Among those respondents who had ever taken antibiotics, a vast majority of them (97.9%) reported they obtained their antibiotics from a doctor.
  • Among respondents (59.7%) who reported that they had consulted a doctor (for cold or flu) in the past 12 months, only a very small proportion of them (2.5%, 19 respondents) had asked for antibiotics during that consultation.
  • When a doctor‘s initial assessment indicated that antibiotics are not needed, the vast majority of respondents (96.9%) would accept the doctor’s advice to observe for a few more days or to wait for the diagnostic test result before deciding whether to prescribe antibiotics or not.
  • Over half of all respondents (54.0%) mistakenly identified cold and flu are treatable with antibiotics.
  • The majority of respondents (73.9%) wanted their doctor to discuss and make a shared-decision with them on antibiotics prescription.
  • A large proportion of respondents have heard of the Chinese term of superbugs (超級細菌) (82.2%), antibiotic-resistant bacteria (抗藥性細菌)(76.2%) or antibiotic resistance (抗生素耐藥性) (67.8%).
  • A large proportion of responders understood the severity of AMR: Many infections are becoming increasingly resistant to treatment by antibiotics ( 79.9%); If bacteria are resistant to antibiotics, it can be very difficult or impossible to treat the infections they cause (73.8%)

 

Recommendations

This study showed that the majority of respondents were aware of antibiotic resistance and its risks. However, half of them considered themselves incapable of stopping the AMR problem. This study also identified that misunderstanding on indications of antibiotics remains prevalent with over half of the respondents mistaking cold and flu as conditions treatable with antibiotics. Awareness-raising activities of the general public should be strengthened to fill this knowledge gap in future health promotion programmes. It is noteworthy that most respondents would comply with doctor’s advice on the need of antibiotics for cold and flu or viral infections. Therefore, health advice and education provided during medical consultations can also serve as a powerful intervention in reducing inappropriate antibiotic use.

Most respondents showed support to potential AMR control measures, including shared decision-making on antibiotic prescription, and most accepted “no antibiotic prescription with watchful-waiting” when the initial medical assessment indicated antibiotics is not needed. To carry this forward, guidelines and training for primary care providers and patient materials can facilitate shared decision-making and “no antibiotic prescription with watchful waiting” practice in community setting. More studies should also be conducted to further assess the needs of prescribers and how the above interventions can be facilitated.

 

The Way Forward

The government launched the Antibiotic Stewardship Programme (ASP) in Primary Care in November 2017, evidence-based guidance notes for common infections encountered by family doctors have been developed with a view to reducing unnecessary prescription and the emergence of AMR.

Health education materials including disease information sheets, posters and pamphlets are available to assist doctors in explaining to patients the nature of disease and the importance of adherence to doctors' instructions. The guidance notes and related materials are accessible in the ASP in Primary Care thematic page.

In order to enhance public’s knowledge and awareness on AMR and proper use of antibiotics, Department of Health had also launched a series of health education and promotion based on the survey result.

The executive summary and the full report can be accessed here.