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Use of the Health Belief Model to Study Patient Perceptions of Antimicrobial Stewardship in the Acute Care Setting

Published online by Cambridge University Press:  26 January 2016

Cydney Heid ,
Mary Jo Knobloch ,
Lucas T. Schulz  and
Nasia Safdar
Cydney Heid
Affiliation:
Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin
Mary Jo Knobloch
Affiliation:
William S. Middleton Memorial Veterans Hospital Madison, Wisconsin
Lucas T. Schulz
Affiliation:
Department of Pharmacy, University of Wisconsin Health, Madison, Wisconsin
Nasia Safdar*
Affiliation:
Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin William S. Middleton Memorial Veterans Hospital Madison, Wisconsin
*
Address correspondence to Nasia Safdar, 5221 MFCB, 1685 Highland Avenue, Madison, WI, 53705 (ns2@medicine.wisc.edu).
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Abstract

OBJECTIVE

To identify themes associated with patient perceptions of antibiotic use and the role of patients in inpatient antimicrobial stewardship.

DESIGN

We conducted semi-structured interviews with 30 hospitalized patients using the Health Belief Model as the framework for questions and analysis.

SETTING

An academic tertiary care hospital in Madison, Wisconsin.

PARTICIPANTS

A total of 30 general medicine inpatients receiving at least 1 anti-infective medication were interviewed.

RESULTS

Participants recognized antibiotic resistance as a serious public health threat but expressed low perceived susceptibility to being personally affected by antibiotic resistance. Views of susceptibility were influenced by a high degree of trust in physicians and misperceptions regarding the mechanisms underlying resistance. Participants expressed high self-efficacy and a desire to be involved in their health care. Perceived roles for patients in preventing the inappropriate use of antibiotics ranged from asking questions and speaking up about concerns to active involvement in decision making regarding antibiotic treatments. Few participants reported being offered the opportunity to engage in such shared decision making while hospitalized.

CONCLUSIONS

Our findings suggest an important role for patients in improving antibiotic use in hospitals. However, patient engagement has not been recognized as a critical component of antimicrobial stewardship programs. Our study suggests that the likelihood of patient engagement in stewardship practices is currently limited by low perceived susceptibility and lack of cues to act. Further investigation into how patients may be engaged as good stewards of antibiotics may reveal new ways to improve antibiotic prescribing practices in the inpatient setting.

Infect Control Hosp Epidemiol 2016;37:576–582

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 5 , May 2016 , pp. 576 - 582
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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