Have the public's expectations for antibiotics for acute uncomplicated respiratory tract infections changed since the H1N1 influenza pandemic? A qualitative interview and quantitative questionnaire study
Identifieur interne : 000963 ( Pmc/Curation ); précédent : 000962; suivant : 000964Have the public's expectations for antibiotics for acute uncomplicated respiratory tract infections changed since the H1N1 influenza pandemic? A qualitative interview and quantitative questionnaire study
Auteurs : Cliodna Mcnulty [Royaume-Uni] ; Puja Joshi [Royaume-Uni] ; Chris C. Butler [Royaume-Uni] ; Lou Atkinson [Royaume-Uni] ; Tom Nichols [Royaume-Uni] ; Angela Hogan [Royaume-Uni] ; David French [Royaume-Uni]Source :
- BMJ Open [ 2044-6055 ] ; 2012.
Abstract
To investigate the effect of the H1N1 influenza pandemic on the public's expectations for a general practice consultation and antibiotic for acute respiratory illness.
Mixed methods.
Qualitative interviews: 17 participants with acute respiratory tract infection (RTI) visiting English pharmacies. Face-to-face survey: about 1700 adults aged 15 years and older were recruited from households in England in January 2008, 2009 and 2011.
The qualitative data indicated that the general public had either forgotten about the ‘swine flu’ (H1N1 influenza) pandemic or it did not concern them as it had not affected them directly or affected their management of their current RTI illness. Between 2009 and 2011, we found that there was little or no change in people's expectations for antibiotics for runny nose, colds, sore throat or cough, but people's expectations for antibiotics for flu increased (26%–32%, p=0.004). Of the 1000 respondents in 2011 with an RTI in the previous 6 months, 13% reported that they took care of themselves without contacting their general practitioners and would not have done so before the pandemic, 9% reported that they had contacted their doctor's surgery and would not have done so before the pandemic and 0.6% stated that they had asked for antibiotics and would not have done so before the pandemic. In 2011, of 123 respondents with a young child (0–4 years) having an RTI in the previous 6 months, 7.4% requested antibiotics and would not have done so before the pandemic. Unprompted, 20% of respondents thought Tamiflu© (oseltamivir) was a vaccine.
Expectations of the general public for a consultation or antibiotics with an RTI are similar now to before the H1N1 influenza pandemic; therefore, public antibiotic campaign messages and general practice advice to patients can remain unchanged. Parents with young children and those with personal experience of the H1N1 influenza are more likely to consult and will need more reassurance. The public need more education about Tamiflu©.
Url:
DOI: 10.1136/bmjopen-2011-000674
PubMed: 22457479
PubMed Central: 3323811
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<author><name sortKey="Hogan, Angela" sort="Hogan, Angela" uniqKey="Hogan A" first="Angela" last="Hogan">Angela Hogan</name>
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<front><div type="abstract" xml:lang="en"><sec><title>Objective</title>
<p>To investigate the effect of the H1N1 influenza pandemic on the public's expectations for a general practice consultation and antibiotic for acute respiratory illness.</p>
</sec>
<sec><title>Design</title>
<p>Mixed methods.</p>
</sec>
<sec><title>Participants</title>
<p>Qualitative interviews: 17 participants with acute respiratory tract infection (RTI) visiting English pharmacies. Face-to-face survey: about 1700 adults aged 15 years and older were recruited from households in England in January 2008, 2009 and 2011.</p>
</sec>
<sec><title>Results</title>
<p>The qualitative data indicated that the general public had either forgotten about the ‘swine flu’ (H1N1 influenza) pandemic or it did not concern them as it had not affected them directly or affected their management of their current RTI illness. Between 2009 and 2011, we found that there was little or no change in people's expectations for antibiotics for runny nose, colds, sore throat or cough, but people's expectations for antibiotics for flu increased (26%–32%, p=0.004). Of the 1000 respondents in 2011 with an RTI in the previous 6 months, 13% reported that they took care of themselves without contacting their general practitioners and would not have done so before the pandemic, 9% reported that they had contacted their doctor's surgery and would not have done so before the pandemic and 0.6% stated that they had asked for antibiotics and would not have done so before the pandemic. In 2011, of 123 respondents with a young child (0–4 years) having an RTI in the previous 6 months, 7.4% requested antibiotics and would not have done so before the pandemic. Unprompted, 20% of respondents thought Tamiflu© (oseltamivir) was a vaccine.</p>
</sec>
<sec><title>Conclusions</title>
<p>Expectations of the general public for a consultation or antibiotics with an RTI are similar now to before the H1N1 influenza pandemic; therefore, public antibiotic campaign messages and general practice advice to patients can remain unchanged. Parents with young children and those with personal experience of the H1N1 influenza are more likely to consult and will need more reassurance. The public need more education about Tamiflu©.</p>
</sec>
</div>
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<journal-id journal-id-type="publisher-id">bmjopen</journal-id>
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<article-meta><article-id pub-id-type="pmid">22457479</article-id>
<article-id pub-id-type="pmc">3323811</article-id>
<article-id pub-id-type="publisher-id">bmjopen-2011-000674</article-id>
<article-id pub-id-type="doi">10.1136/bmjopen-2011-000674</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Public Health</subject>
<subj-group><subject>Research</subject>
</subj-group>
</subj-group>
<subj-group subj-group-type="hwp-journal-coll"><subject>1506</subject>
<subject>1724</subject>
<subject>1696</subject>
<subject>1725</subject>
</subj-group>
</article-categories>
<title-group><article-title>Have the public's expectations for antibiotics for acute uncomplicated respiratory tract infections changed since the H1N1 influenza pandemic? A qualitative interview and quantitative questionnaire study</article-title>
<alt-title alt-title-type="short">Should we change our antibiotic messages following the H1N1 influenza pandemic?</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>McNulty</surname>
<given-names>Cliodna</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Joshi</surname>
<given-names>Puja</given-names>
</name>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Butler</surname>
<given-names>Chris C</given-names>
</name>
<xref ref-type="aff" rid="aff3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Atkinson</surname>
<given-names>Lou</given-names>
</name>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nichols</surname>
<given-names>Tom</given-names>
</name>
<xref ref-type="aff" rid="aff4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hogan</surname>
<given-names>Angela</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>French</surname>
<given-names>David</given-names>
</name>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label>
Health Protection Agency, Primary Care Unit, Department of Microbiology, Gloucestershire Royal Hospital, Gloucester, UK</aff>
<aff id="aff2"><label>2</label>
Applied Research Centre in Health and Lifestyles Interventions, Coventry University, Coventry, UK</aff>
<aff id="aff3"><label>3</label>
Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK</aff>
<aff id="aff4"><label>4</label>
Statistics Unit, Centre for Infections, Health Protection Agency, London, UK</aff>
<author-notes><corresp><bold>Correspondence to</bold>
Dr Cliodna McNulty; <email>cliodna.mcnulty@hpa.org.uk</email>
</corresp>
<fn fn-type="other"><p>The Lloyds pharmacy group commented on interviewee information leaflets and pharmacy poster, provided data on Tamiflu© dispensing and commented on the suitability of selected pharmacies, in terms of layout and staffing, for the study, but otherwise had no influence on the study design or interviewee selection.</p>
</fn>
</author-notes>
<pub-date pub-type="collection"><year>2012</year>
</pub-date>
<pub-date pub-type="epub"><day>27</day>
<month>3</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>27</day>
<month>3</month>
<year>2012</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on the
. </pmc-comment>
<volume>2</volume>
<issue>2</issue>
<elocation-id>e000674</elocation-id>
<history><date date-type="received"><day>29</day>
<month>11</month>
<year>2011</year>
</date>
<date date-type="accepted"><day>21</day>
<month>2</month>
<year>2012</year>
</date>
</history>
<permissions><copyright-statement>© 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</copyright-statement>
<copyright-year>2012</copyright-year>
<license license-type="open-access"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/">http://creativecommons.org/licenses/by-nc/2.0/</ext-link>
and <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/legalcode">http://creativecommons.org/licenses/by-nc/2.0/legalcode</ext-link>
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<self-uri content-type="draft-revisions-pdf" xlink:type="simple" xlink:href="bmjopen-2011-000674.draft_revisions.pdf"></self-uri>
<self-uri content-type="reviewers-comments-pdf" xlink:type="simple" xlink:href="bmjopen-2011-000674.reviewer_comments.pdf"></self-uri>
<abstract><sec><title>Objective</title>
<p>To investigate the effect of the H1N1 influenza pandemic on the public's expectations for a general practice consultation and antibiotic for acute respiratory illness.</p>
</sec>
<sec><title>Design</title>
<p>Mixed methods.</p>
</sec>
<sec><title>Participants</title>
<p>Qualitative interviews: 17 participants with acute respiratory tract infection (RTI) visiting English pharmacies. Face-to-face survey: about 1700 adults aged 15 years and older were recruited from households in England in January 2008, 2009 and 2011.</p>
</sec>
<sec><title>Results</title>
<p>The qualitative data indicated that the general public had either forgotten about the ‘swine flu’ (H1N1 influenza) pandemic or it did not concern them as it had not affected them directly or affected their management of their current RTI illness. Between 2009 and 2011, we found that there was little or no change in people's expectations for antibiotics for runny nose, colds, sore throat or cough, but people's expectations for antibiotics for flu increased (26%–32%, p=0.004). Of the 1000 respondents in 2011 with an RTI in the previous 6 months, 13% reported that they took care of themselves without contacting their general practitioners and would not have done so before the pandemic, 9% reported that they had contacted their doctor's surgery and would not have done so before the pandemic and 0.6% stated that they had asked for antibiotics and would not have done so before the pandemic. In 2011, of 123 respondents with a young child (0–4 years) having an RTI in the previous 6 months, 7.4% requested antibiotics and would not have done so before the pandemic. Unprompted, 20% of respondents thought Tamiflu© (oseltamivir) was a vaccine.</p>
</sec>
<sec><title>Conclusions</title>
<p>Expectations of the general public for a consultation or antibiotics with an RTI are similar now to before the H1N1 influenza pandemic; therefore, public antibiotic campaign messages and general practice advice to patients can remain unchanged. Parents with young children and those with personal experience of the H1N1 influenza are more likely to consult and will need more reassurance. The public need more education about Tamiflu©.</p>
</sec>
</abstract>
<abstract abstract-type="summary"><title>Article summary</title>
<sec><title>Article focus</title>
<sec><title>Hypothesis</title>
<list list-type="bullet"><list-item><p>The H1N1 (2009) pandemic has ‘medicalised’ acute respiratory illness presenting with flu-like symptoms, including cough, cold, sore throat and fever.</p>
</list-item>
<list-item><p>The general public may now have a greater expectation that they should seek a consultation with a health professional and have a greater expectation for antibiotics when they next have an acute respiratory illness presenting with flu-like symptoms, including cough, cold, sore throat and fever.</p>
</list-item>
</list>
</sec>
<sec><title>Aims</title>
<list list-type="bullet"><list-item><p>To determine if expectations for a consultation or an anti-infective have changed as a result of the publics' experiences of the recent (2009) H1N1 influenza pandemic and to explore the publics' understanding of anti-infectives.</p>
</list-item>
</list>
</sec>
</sec>
<sec><title>Key messages</title>
<list list-type="bullet"><list-item><p>The H1N1 influenza pandemic has not changed the general public's expectations for a general practitioner's consultation or antibiotics when they have a runny nose, cough, cold or sore throat but may have increased people's expectations for antibiotics for influenza.</p>
</list-item>
<list-item><p>Most have either forgotten about the influenza outbreak or it did not concern them as it had not affected them directly.</p>
</list-item>
<list-item><p>The smaller subsets of the public with young children and those who have had suspected or confirmed H1N1 influenza themselves are now more likely to consult and request an antibiotic for an RTI and, therefore, these groups will need more guidance and reassurance.</p>
</list-item>
<list-item><p>A fifth of the public believe that Tamiflu© (oseltamivir) is a vaccine, implying that enhanced information sharing is needed in this area.</p>
</list-item>
</list>
</sec>
<sec><title>Strengths and limitations of this study</title>
<list list-type="bullet"><list-item><p>This was a large survey of the general population, repeating some of the questions asked before the 2009 H1N1 flu epidemic, using the same sampling methods.</p>
</list-item>
<list-item><p>The qualitative interviews had recruitment problems with many potential interviewees not being at home when telephoned. However, the purpose of qualitative interviews was mainly to enrich our data, and they did help explain our quantitative findings.</p>
</list-item>
<list-item><p>The questionnaire survey asked to recall their most recent RTI in the previous 6 months and what actions they took on that occasion. This will be subject to some recall bias.</p>
</list-item>
</list>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
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