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Impact of antibiotic side effects and allergies on patient adherence and attitudes: a mixed methods study in England
Liam Michael Clayton1, Catherine V Hayes1, Luke O'Neill1
1Primary Care and Interventions Unit, UK Health Security Agency, England, UK.
Background:
The overuse and misuse of antibiotics significantly contributes to antimicrobial resistance (AMR). Adverse reactions to antibiotics are well documented, but their impact on patients' behaviours requires further exploration.
Aim:
To explore how side effects and allergies influence patients' behaviours to prescribed antibiotic use.
Design & Setting:
A mixed-methods explanatory sequential study in England.
Method:
A survey of 1059 adults with prior experience of antibiotic side effects was conducted. Descriptive statistics identified common side effects and behavioural responses, while chi-squared tests explored demographic differences. Focus groups were held with 21 participants, recruited through a research panel. Thematic analysis captured deeper insight into participants' personal experiences.
Results:
Many antibiotic side effects were identified, presenting shortly after consumption and affecting several aspects of patients' lives. One-third of respondents (31%, n=325; 95% CI: 28-34%) were unaware of potential side effects beforehand, citing inaccessible patient information leaflets and limited communication from healthcare professionals as barriers. Almost half (42%, n=440; 95% CI: 37-47%) did not complete their antibiotic course following the side effects, with 32% (n=142; 95% CI: 28-37%) stopping without medical advice. Many allergy diagnoses were made in childhood without follow-up assessments.
Conclusion:
Antibiotic side effects can significantly disrupt patients' lives and discourage appropriate use of antibiotics. Providing accessible information before prescribing may help manage expectations and support self-management of side effects. Patients with longstanding allergy labels should be encouraged to undergo reassessment to ensure that they are not contributing to AMR by unnecessarily avoiding the use of first-line antibiotics.
Insights
Antibiotic side effects impact patient behavior, leading many to stop treatment prematurely. Improved communication and reassessment of allergies are crucial for appropriate antibiotic use and combating antimicrobial resistance.
Area of Science:
- Pharmacology
- Patient Behavior Studies
- Public Health
Background:
- Antibiotic misuse fuels antimicrobial resistance (AMR).
- While antibiotic adverse reactions are known, their effect on patient behavior needs more study.
Purpose of the Study:
- To investigate how antibiotic side effects and allergies influence patient behavior regarding prescribed antibiotic use.
Main Methods:
- A mixed-methods study in England involving a survey of 1059 adults and focus groups with 21 participants.
- Descriptive statistics, chi-squared tests, and thematic analysis were used to analyze data.
Main Results:
- Many patients experienced disruptive antibiotic side effects.
- A third were unaware of potential side effects due to poor information access.
- Nearly half did not complete antibiotic courses after experiencing side effects, with many stopping treatment without medical advice.
Conclusions:
- Antibiotic side effects significantly affect patients and can lead to inappropriate use, contributing to AMR.
- Enhanced patient information and reassessment of allergy labels are recommended to improve antibiotic adherence and management.
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