Interview-based cross-sectional needs assessment to advance the implementation of an effective antibiotic stewardship program in Indonesian hospitals

Herawati, Fauna; Ananta, Sheny Clarin; Parwitha, Ida Ayu Andri; Ressandy, Sylvan Septian; Rahmatin, Nur Laili; Rachmadini, Nur Afifah; Tangalobo, Veronika Ayu; Setiasih, Setiasih; Yulia, Rika; Woerdenbag, Herman J.; Avanti, Christina

doi:10.1016/j.hpopen.2019.100002

Cited by 14 publications

(21 citation statements)

References 21 publications

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“…Various measures need to be taken to prevent the development of antibiotic resistance and to reduce the spread of it [16]. One important aspect is to educate the public on how to use antibiotics correctly, and to convince them not to buy antibiotics without a prescription [17]. The most important patient-related factor is the lack of knowledge about antibiotics and their responsible use [18].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it is necessary to increase the patients' knowledge by providing reliable information and education about antibiotics and their use [17,20]. In addition, it is not only important to consider the required content of the information that should be delivered to the patients, but also the information media used for conveying the message [21].…”

Section: Introductionmentioning

confidence: 99%

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Educational Video Improves Knowledge about Outpatients’ Usage of Antibiotics in Two Public Hospitals in Indonesia

et al. 2021

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The inappropriate use or misuse of antibiotics, particularly by outpatients, increases antibiotic resistance. A lack of public knowledge about “Responsible use of antibiotics” and “How to obtain antibiotics” is a major cause of this. This study aimed to assess the effectiveness of an educational video about antibiotics and antibiotic use to increase outpatients’ knowledge shown in two public hospitals in East Java, Indonesia. A quasi-experimental research setting was used with a one-group pre-test—post-test design, carried out from November 2018 to January 2019. The study population consisted of outpatients to whom antibiotics were prescribed. Participants were selected using a purposive sampling technique; 98 outpatients at MZ General Hospital in the S regency and 96 at SG General Hospital in the L regency were included. A questionnaire was used to measure the respondents’ knowledge, and consisted of five domains, i.e., the definition of infections and antibiotics, obtaining the antibiotics, directions for use, storage instructions, and antibiotic resistance. The knowledge test score was the total score of the Guttman scale (a dichotomous “yes” or “no” answer). To determine the significance of the difference in knowledge before and after providing the educational video and in the knowledge score between hospitals, the (paired) Student’s t-test was applied. The educational videos significantly improved outpatients’ knowledge, which increased by 41% in MZ General Hospital, and by 42% in SG General Hospital. It was concluded that an educational video provides a useful method to improve the knowledge of the outpatients regarding antibiotics.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Educational Video Improves Knowledge about Outpatients’ Usage of Antibiotics in Two Public Hospitals in Indonesia

et al. 2021

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show abstract

“…Various measures need to be taken to prevent the development of antibiotic resistance and to reduce the spread of it [16]. An important aspect is to educate the public as to using antibiotics correctly and to convince them not to buy antibiotics without prescription [17]. The most important patient-related factor is the lack of knowledge about antibiotics and their use [18].…”

Section: Introductionmentioning

confidence: 99%

“…The people perceive that antibiotics are a 'super drugs' for any possible disease, and that they can cure minor ailments caused by viruses, such as flu, colds, and fever [18,19]. It is thus necessary to increase the patients' knowledge by providing reliable information and education about antibiotics and their use [17,20]. It is also important to not only to consider the required content of the information to be delivered, but also the information media used for conveying the message [21].…”

Section: Introductionmentioning

confidence: 99%

Educational Video Improves the Knowledge about Outpatients’ Usage of Antibiotics in Hospital

Herawati¹,

Yulia²,

Arifin³

et al. 2021

Preprint

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Irrational use or misuse of antibiotics, particularly by outpatients, increases antibiotic resistance. A lack of public knowledge about ‘Responsible use of antibiotics’ and ‘How to obtain antibiotics’ is a major cause of this. This study aimed to assess the effectiveness of an educational video about antibiotics and antibiotics use to increase outpatient's knowledge in two public hospitals in East Java, Indonesia. A quasi-experimental research setting was used with a one-group pretest-posttest design, carried out from November 2018 to January 2019. The study population consisted of outpatients, to whom antibiotics were prescribed, in two public hospitals in East Java, Indonesia. Participants were selected using a purposive sampling technique; 98 outpatients at MZ General Hospital in S regency and 96 at SG General Hospital in L regency were included. A questionnaire was used to measure the respondents’ knowledge and consisted of five domains, i.e. definition of infections and antibiotics, obtaining the antibiotics, directions of use, storage instructions, antibiotic resistance. The knowledge test score was the total score of the Guttman scale (a dichotomy of ‘yes’ or ‘no’ answers). To determine the significance of the difference in knowledge before and after providing the educational video and in the knowledge score between hospitals, the (paired) Student’s t-test was applied. The educational videos significantly improved outpatients' knowledge, which increased with 41% in MZ General Hospital and 42% in SG General Hospital. An educational video is a useful method to improve the knowledge of the outpatients regarding antibiotics.

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“…Indonesia, a diverse middle-income country in Southeast Asia with the world’s fourth largest population (275 million), is particularly vulnerable for AMR, driven by dense urban populations combined with rising antibiotic consumption 13 , a decentralised health system 14 , and weakly enforced antibiotic policies 15 , hence promoting inappropriate prescribing and over-the-counter access without a prescription. Despite progress in government policies, AMS is generally in an early stage of implementation 15,16 .…”

Section: Introductionmentioning

confidence: 99%

Perceptions, views and practices regarding antibiotic prescribing and stewardship among hospital physicians in Jakarta, Indonesia

Limato

Nelwan

Mudia

et al. 2021

Preprint

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Objectives: Antibiotic overuse is one of the main drivers of antimicrobial resistance (AMR), especially in low and middle-income countries. This study aimed to gain an understanding of perceptions, views, and practices regarding AMR, antibiotic prescribing, and stewardship (AMS) among hospital physicians in Jakarta, Indonesia. Design: cross-sectional, self-administered questionnaire-based survey, with descriptive statistics, exploratory factor analysis (EFA) to identify distinct underlying constructs in the dataset, and multivariable linear regression of factor scores to analyse physician subgroups. Setting: Six public and private general hospitals in Jakarta in 2019. Participants: 1007 of 1896 (53.1% response rate) antibiotic prescribing physicians. Results: EFA identified six latent factors (overall Crohnbach alpha=0.85): awareness of AMS activities; awareness of AMS purpose; views regarding rational antibiotic prescribing; confidence in antibiotic prescribing decisions; perception of AMR as a significant problem; and immediate actions to contain AMR. Physicians acknowledged the significance of AMR and contributing factors, rational antibiotic prescribing, and purpose and usefulness of AMS. However, this conflicted with reported suboptimal local hospital practices, such as room cleaning, hand hygiene and staff education, and views regarding antibiotic decision-making. These included insufficiently applying AMS principles and utilising microbiology, lack of confidence in prescribing decisions, and defensive prescribing due to pervasive diagnostic uncertainty, fear of patient deterioration or because patients insisted. Physicians factor scores differed across hospitals, departments, work experience and medical hierarchy. Conclusions: AMS implementation in Indonesian hospitals is challenged by institutional, contextual and diagnostic vulnerabilities, resulting in externalising AMR instead of recognising it as a local problem. Appropriate recognition of the contextual determinants of antibiotic prescribing decision-making will be critical to change physicians attitudes and develop context-specific AMS interventions

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Interview-based cross-sectional needs assessment to advance the implementation of an effective antibiotic stewardship program in Indonesian hospitals

Cited by 14 publications

References 21 publications

Educational Video Improves Knowledge about Outpatients’ Usage of Antibiotics in Two Public Hospitals in Indonesia

Educational Video Improves Knowledge about Outpatients’ Usage of Antibiotics in Two Public Hospitals in Indonesia

Educational Video Improves the Knowledge about Outpatients’ Usage of Antibiotics in Hospital

Perceptions, views and practices regarding antibiotic prescribing and stewardship among hospital physicians in Jakarta, Indonesia

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