AsianScientist (Feb. 28, 2019) – Contextual information like long patient journeys or the abundance of antibiotics influence how healthcare providers in low- to middle-income countries dispense antibiotics, according to a study by a research group in the UK. Their findings are published in Trials.
While antibiotics have been immensely useful in the fight against infection, their overuse has resulted in the rapid rise of resistant microbes. As a result, researchers and clinicians the world over have called for tighter controls on the supply and use of antibiotics.
However, in developing countries, fears over leaving infectious diseases untreated, coupled with a lack of enforcement of antibiotic supply measures, could lead to imprudent antibiotic use, according to scientists led by Assistant Professor Marco J Haenssgen of the University of Warwick, UK.
Analyzing clinical trials in Myanmar, Thailand and Vietnam with a total of 4,446 participants, the researchers found that although a five-minute finger-prick blood test was available to help healthcare workers decide whether bacteria was the cause of the febrile illness, physicians frequently prescribed antibiotics despite a negative test result.
The researchers also examined qualitative material from 130 interview and group discussion participants across the three countries to show that if antibiotics were over-abundant or if healthcare workers were worried about deadly infectious diseases, they were less likely to follow the guidance provided by the biomarker test.
Similarly, if long and dangerous journeys prevented patients from follow-up visits to primary health centers or if they struggled to understand the purpose of the test, then patients may be more likely to ignore the results and buy antibiotics without prescriptions from local grocery stores and pharmacies.
“For researchers, more contextual data from clinical trials means that we will be able to carry out meta-analyses to identify which contextual factor (e.g. poverty, complementary health policy) matters for the successful operation of a new intervention [to reduce antibiotic use in developing countries]. That would then inform a design toolkit for clinicians that can guide them in identifying appropriate interventions, or advocating for changes in policy,” said Haenssgen.
The article can be found at: Haenssgen et al. (2019) How Context Can Impact Clinical Trials: a Multi-country Qualitative Case Study Comparison of Diagnostic Biomarker Test Interventions.
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Source: University of Warwick; Photo: Shutterstock.
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