Implementation of the WHO Approved “Tailoring Antimicrobial Resistance Programs (TAP)” Reduces Patients’ Request for Antibiotics

Abstract

The misuse of antibiotics is a worldwide public health concern. Behavioral Intervention programs that aim to reduce patients’ own request for antibiotics during their visit to primary care clinics is an attractive strategy to combat this problem. We tested the effectiveness of a behavioral modification method known as the Tailoring Antimicrobial resistance Programs (TAP) in reducing the request for antibiotics by patients visiting primary care clinics for mild upper respiratory tract infections (URTIs). A stratified cluster randomized design with two groups pre-post, comparing intervention with the control, was conducted in six health centers. TAP was implemented for eight weeks. Request for antibiotics was assessed before (period 1) and after introducing TAP (period 2). The percentage of patients or their escorts who requested antibiotics in period 1 was 59.7% in the control group and 60.2% in the intervention group. The percentage of patients who requested antibiotics did not significantly change between period 1 and 2 in the control group, who continued to receive the standard of care. The above percentage significantly decreased in the intervention group from 60.2% to 38.5% (p < 0.05). We conclude that behavioral change programs including TAP are a viable alternative strategy to address antibiotic misuse in Jordan.

Fostering Appropriate Antibiotic Use in a Complex Intervention: Mixed-Methods Process Evaluation Alongside the Cluster-Randomized Trial ARena

“…Though knowledge dissemination about behavior change techniques was not part of the ARena implementation program, physicians reported their intuitive use to antagonize patients’ antibiotic-demands. Such intuitive use of behavior change techniques could be supported by applying the Tailored Antimicrobial Resistance Program (TAP), which was developed by the World Health Organization (WHO) [ 44 ]). TAP as a concept targets the conversion of habits supporting antimicrobial resistances by offering guidance in design, implementation and evaluation of such strategies.…”

“…It was tested in a pilot study designed in a stratified cluster randomized trial. During an implementation period of eight weeks, patient requests for antibiotics significantly decreased from 60.2% to 38.5% ( p < 0.05) [ 44 ]. This strongly suggests that using behavior change techniques might be a powerful tool in the context of antibiotic resistances and indicates that future interventions could focus them more closely.…”

Fostering Appropriate Antibiotic Use in a Complex Intervention: Mixed-Methods Process Evaluation Alongside the Cluster-Randomized Trial ARena

“…It was tested in a pilot study designed in a stratified cluster randomized trial. During an implementation period of eight weeks, patient requests for antibiotics significantly decreased from 60.2% to 38.5% (p<0.05) [42].…”

“…Though knowledge dissemination about behavior change techniques was not part of the ARena implementation program, physicians reported their intuitive use to antagonize patients' antibiotic-demands. Such intuitive use of behavior change techniques could be supported by applying the Tailored Antimicrobial Resistance Program (TAP) which was developed by the World Health Organization (WHO) [42]). TAP as a concept targets the conversion of habits supporting antimicrobial resistances by offering guidance in design, implementation and evaluation of such strategies.…”

Developing a theory-based behavior change intervention to improve the prescription of surgical prophylaxis in an Egyptian University Hospital.

“…Many social and cultural factors in uence antibiotic prescribing practices in acute care settings. These need to be understood in their given context in order to promote behaviour change [14][15][16]. Behaviour change interventions that only rely on education or policy change often have limited impact on changing behaviours [21,22], and should be supplemented by addressing the cultural factors in uencing prescribing practices.…”