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Patient Attitudes Regarding Participation in Studies of Antimicrobial Resistance

Published online by Cambridge University Press:  02 January 2015

Pam Tolomeo ,
Mary Wheeler ,
Joshua P. Metlay ,
Katrina Armstrong ,
Neil O. Fishman ,
Warren B. Bilker  and
Ebbing Lautenbach
Pam Tolomeo
Affiliation:
Center for Clinical Epidemiology and Biostatistics, Department of Medicine, Philadelphia, Pennsylvania
Mary Wheeler
Affiliation:
Center for Clinical Epidemiology and Biostatistics, Department of Medicine, Philadelphia, Pennsylvania Center for Bioethics, Department of Medicine, Philadelphia, Pennsylvania
Joshua P. Metlay
Affiliation:
Center for Clinical Epidemiology and Biostatistics, Department of Medicine, Philadelphia, Pennsylvania Center for Education and Research on Therapeutics, Department of Medicine, Philadelphia, Pennsylvania Divisions of General Internal Medicine, Department of Medicine, Philadelphia, Pennsylvania Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Department of Veterans Affairs, Philadelphia, Pennsylvania
Katrina Armstrong
Affiliation:
Center for Clinical Epidemiology and Biostatistics, Department of Medicine, Philadelphia, Pennsylvania Divisions of General Internal Medicine, Department of Medicine, Philadelphia, Pennsylvania Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Neil O. Fishman
Affiliation:
Center for Education and Research on Therapeutics, Department of Medicine, Philadelphia, Pennsylvania Infectious Diseases, Department of Medicine, Philadelphia, Pennsylvania
Warren B. Bilker
Affiliation:
Center for Clinical Epidemiology and Biostatistics, Department of Medicine, Philadelphia, Pennsylvania Center for Education and Research on Therapeutics, Department of Medicine, Philadelphia, Pennsylvania Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Ebbing Lautenbach*
Affiliation:
Center for Clinical Epidemiology and Biostatistics, Department of Medicine, Philadelphia, Pennsylvania Center for Education and Research on Therapeutics, Department of Medicine, Philadelphia, Pennsylvania Infectious Diseases, Department of Medicine, Philadelphia, Pennsylvania Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
*
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, 825 Blockley Hall, 423 Guardian Dr., Philadelphia, PA 19104-6021 (ebbing@mail.med.upenn.edu)
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Abstract

Background.

A number of recent studies of antimicrobial resistance have focused on the role of antimicrobial-resistant pathogens that colonize the gastrointestinal tract. However, participation rates have been low in studies that involve fecal sampling. Attitudes toward such studies among potential study participants have not been assessed.

Methods.

We conducted a cross-sectional survey, enrolling 3 groups of inpatients from a large academic center. Group 1 consisted of patients who had previously participated in a cohort study of fluoroquinolone-resistant Escherichia coli, which involved the collection of perirectal swab samples. Group 2 consisted of patients who had previously refused to participate in the study of fluoroquinolone-resistant E. coli. Group 3 consisted of patients who had never been asked to participate in the study of the fluoroquinolone-resistant E. coli. The survey assessed patients' attitudes and beliefs regarding medical research and their willingness to consent to collection of a perirectal swab sample. Response options were recorded on a 5-point Likert scale. The Fisher exact test was used to compare dichotomized responses across study groups.

Results.

A total of 90 patients were surveyed: there were 29 in group 1 and in group 2 and 32 in group 3. Of 90 patients, 31 (35%) believed researchers might run additional tests on collected samples without informing the patient, whereas 25 (27%) believed persons other than the research team might gain access to study results. The belief that a person could get sicker as a result of a having a perirectal swab sample collected was significantly more common among patients who had previously refused to participate in the fluoroquinolone-resistant E. coli study.

Conclusion.

This study highlights important beliefs and attitudes that are associated with the likelihood of participating in studies of antimicrobial resistance. Explicitly addressing these concerns with eligible patients is critical to optimize participation in future studies.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 29 , Issue 2 , February 2008 , pp. 155 - 159
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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