Attitude towards antibiotic use

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knowledge and attitude towards antibiotics among consumers. (Gonzales ... Validated, self-administered questionnaire (Lim & Teh, 2012). Comprised of 4 ...
KNOWLEDGE AND ATTITUDE TOWARDS ANTIBIOTICS AMONG PATIENTS IN A TERTIARY HOSPITAL IN KELANTAN Ahmad Syafiq Zaim, Nurul Syamimi Hamat, Annuysia Mageswaran, Hasniza Mohamed, Nazmi Liana Azmi Department of Pharmacy, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan

Introduction Antibiotic consumption is a significant predictor in the emergence of resistance. Excessive use of antibiotics is associated with increase rate of resistant bacteria (Cars & Nordberg, 2004). 2. Among the key factors leading to uncontrolled use of antibiotics are problems in knowledge, attitude, beliefs and behaviours among public. 3. Several studies conducted worldwide reported inappropriate knowledge and attitude towards antibiotics among consumers (Gonzales, Steiner & Sande, 1997; Oh et al., 2010; Lim & Teh, 2012; Pereko, Lubbe & Essack, 2015; Awad & Aboud, 2015). 1.

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Rationale of Study  There were only two studies reported in Malaysia which assess

public knowledge and attitude towards antibiotic use (Oh et al., 2010 & Lim & Teh, 2012). In view of the different geographic locations, this study was conducted to gather local data among patients attending outpatient pharmacy in Hospital Raja Perempuan Zainab II (HRPZ II), Kelantan.

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Objectives General Objective:  To investigate the level of knowledge and attitude towards antibiotic use among patients attending outpatient pharmacy in HRPZ II, Kelantan. Specific Objectives:  To determine the relationship between demographic characteristics and knowledge as well as attitude.  To identify the areas of inappropriate responses for knowledge and attitude statements. 4

Methodology Study Design  Cross-sectional study

Study Duration  October 2015 - January 2016 Sampling Method  Convenience sampling

Study Population  Patients attending outpatient pharmacy in HRPZ II, Kelantan 5

Methodology Inclusion Criteria  Patients aged 18 years old and above  Able to speak and write in Bahasa Malaysia

Exclusion Criteria  Patients who had never been prescribed with antibiotics  Psychiatric patients

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Methodology Sample Size  Sample size was calculated based on formula for a classical cross-sectional study (Naing, 2009). Utilizing the values below, minimum sample size was 155 (Actual sample achieved = 158)

n = p1(1 – p1) + p2(1 – p2) (p1 – p2)2

x (zα + zβ)2

Level of significance, α = 0.05 Power, (1 – β) = 0.80 p1 = 0.61 (expected proportion of patients with appropriate attitude based on expert opinion) p2 = 0.7 (proportion of patients with appropriate attitude in the population given by Lim and Teh, 2012)

Appropriate knowledge: p1 = 0.41, p2 = 0.51; minimum sample size 7

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Methodology Instrument  Validated, self-administered questionnaire (Lim & Teh, 2012)  Comprised of 4 parts: Part I - demographic characteristics Part II - recent use of antibiotics Part III - 12 knowledge statements ; “Yes”, “No” or “Not Sure” Part IV - 8 attitude statements; 5-point Likert scale (1=strongly disagree; 2=disagree; 3=not sure; 4=agree; 5=strongly agree). 8

Methodology Statistical Analysis  Data were analyzed using SPSS version 22.0. ANALYSIS

VARIABLES

OUTCOME

Descriptive statistics

Demographic characteristics, recent antibiotics Frequencies consumption, knowledge and attitude scores, Percentages inappropriate responses for knowledge and attitude Mean(SD) statements

Independent t-test or one-way ANOVA

The influence of demographic characteristics on knowledge and attitude scores (categorical vs numerical)

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p-value of < 0.05 was considered as statistically significant

Results  200 questionnaires were distributed  164 questionnaires were returned (82.0% response rate)  6 questionnaires were incomplete

 Total final sample: 158 questionnaires

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Results PART I - Demographic characteristics (Table I)  Most respondents were Malay (n=137, 86.7%), female (n=102, 64.6%), of 18-45 years old (n=132, 83.5%) with tertiary education (n=88, 55.7%).  42.4% (n=67) were employed with 27.8% (n=44) worked in healthcare-related occupation.  Mean knowledge score and mean attitude score were significantly influenced by: education level (p