David, Crystal M.

Johnson, Jeremy L.

Miller, Michael J.

O’Neal, Katherine S.

English

SWOSU Digital Commons (Southwestern Oklahoma State University)

Southwestern Oklahoma State UniversitySWOSU Digital CommonsFaculty Articles & Research Pharmacy Practice5-6-2016Literacy-Sensitive Approach to ImprovingAntibiotic Understanding in a Community-BasedSettingCrystal M. DavidUniveristy of Oklahoma College of MedicineKatherine S. O’NealCherokee Nation WW Hastings HospitalMichael J. MillerUniversity of Oklahoma College of MedicineJeremy L. JohnsonSouthwestern Oklahoma State University, jeremy.johnson@swosu.eduFollow this and additional works at: https://dc.swosu.edu/cop_pp_articlesThis Poster is brought to you for free and open access by the Pharmacy Practice at SWOSU Digital Commons. It has been accepted for inclusion inFaculty Articles & Research by an authorized administrator of SWOSU Digital Commons. An ADA compliant document is available upon request. Formore information, please contact phillip.fitzsimmons@swosu.edu.Recommended CitationDavid, Crystal M.; O’Neal, Katherine S.; Miller, Michael J.; and Johnson, Jeremy L., "Literacy-Sensitive Approach to ImprovingAntibiotic Understanding in a Community-Based Setting" (2016). Faculty Articles & Research. 15.https://dc.swosu.edu/cop_pp_articles/15Literacy-Sensitive Approach to Improving Antibiotic Understandingin a Community-Based SettingCrystal M. David, PharmD1; Katherine S. O’Neal, PharmD, MBA, BCACP, CDE, BC-ADM, AE-C2;Michael J. Miller, RPh, DrPH, FAPhA3; Jeremy L. Johnson, PharmD, BCACP CDE, BC-ADM4; Ann E. Lloyd, PharmD, BCPS, BCSP-AQ ID2 1 Univeristy o f Oklahoma College o f Medicine, Cherokee Nation WW  Hastings Hospital; 2University of Oklahoma College of Pharmacy, Saint Francis Hospital; 3University o f Oklahoma College o f Medicine; 4Southwestern Oklahoma State University College of PharmacyBackgroundAntibiotic Usage• Overuse and misuse of antibiotics contribute to antibiotic- resistant bacterial infections1• Over 2 million people develop severe antibiotic-resistant infections every year with 23,000 deaths and an estimated $20 billion in healthcare costs1-2• 45% of patients responding to a telephone survey believed viruses could be treated using antibiotics3• 47% of adults surveyed do not always take the full course of antibiotics4Patient Impact• 46% of adults surveyed call their provider to ask for antibiotics when they have a cold or the flu4• Unnecessary antibiotics were prescribed 80% of the time when some form of patient pressure was witnessed5• 46% of patients with URTIs who came to their physician expecting an antibiotic received one; 29% who did not expect an antibiotic received a prescription for one6• 27% of prescriptions were written for treatment of illnesses for which an antibiotic was not indicated7Role of Health Literacy• ".  .the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions”8• Given that approximately 36% of adult Americans were reported to have basic or below basic health literacy skills,9 literacy may play a role in antibiotic use• No studies were identified relating health literacy to antibiotic knowledge or useSpecific Aims• This study• Developed and deployed a program to enhance patient knowledge about antibiotic use• Evaluated whether providing patient education is associated with improvements in antibiotic knowledge• Explored the association between antibiotic knowledge and health literacyMethods• This study was approved by the University of Oklahoma Health Sciences Center Institutional Review BoardSample• 28 eligible, community-dwelling participants from within the Tulsa, OK metropolitan area• > 18  years old• English-speakingStudy Design• Prospective, pre-test post-test study• Participant sociodemographic characteristics, including a m easurem ent of health literacy, were collected at baseline• Antibiotic knowledge (perceptions of appropriate use) were collected before and after the educational seminar• Knowledge index constructed -  summation of correct answersStudy Implementation• An informational flyer with scheduled program times was utilized to recruit participants• Participants completed:• Brief demographic survey• The Newest Vital Sign (NVS) health literacy survey• 14-item pre-test evaluation of current antibiotic knowledge (randomized to 2/3 of participants -  19)• All participants received:• 30-minute educational PowerPoint presentation• 14-item post-test evaluation about antibiotic knowledgeStatistical Analysis• Descriptive statistics were used to described the sample• Wilcoxon signed rank tests and a dependent sam ples t-test were used to compare individual and cumulative pre/post antibiotic knowledge scores• Pearson correlations were used to a sse ss  relationship between health literacy and pre-post antibiotic knowledge scores• Kuder-Richardson 20 (KR20) was used to a s se ss  instrument reliability• Stata 14.1© was used for analyses with a-priori alpha=0.05Results• 19 participants completed the seminar and both pre- and post­tests• Overall antibiotic knowledge index significantly increased by 2 points (12.95 vs. 10.95, p=0.0011)• Health literacy (NVS scores) was not significantly correlated with pre-test antibiotic knowledge scores (r=0.24, p=0.22), but was significantly correlated to post-test antibiotic knowledge scores (r=0.62, p=0.0004)• Test reliability was 0.79 and 0.70 for pre- and post-tests, respectively• All participants• Scored lower on subset statements reflecting treatment of virusesConclusion• Patients have limited understanding of bacteria versus viruses and treatment• Educational programs can improve antibiotic use knowledge• The educational program may be more effective for those with higher literacy levelsReferences1. Center for Disease Control and Prevention. Antibiotic Resistance Threats in the United States, 2013. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services;2013.2. Mohess A, Baker T. Antibiotic-resistant infections cost the U.S. healthcare system in excess of $20 billion annually. Biomerieux. http://www.biomerieux-usa.com. Published 2009. Accessed July 22,2014.3. Foster S, Boyd S, Edgar T. Patient behaviors and beliefs regarding antibiotic use. Alliance for the Prudent Use of Antibiotics (APUA). http://www.tufts.edu/med/apua. Published September 2010. Accessed July 15, 2014.4. County of Los Angeles Department of Health Services. Antibiotic Misuse. Los Angeles, CA: Los Angeles County Department of Health Services; 2003.5. Scott JG, Cohen D, DiCiddo-Bloom B, OrzanoAJ, Jaen CR, Crabtree BF. Antibiotic use in acute respiratory infections and the ways patients pressure physicians for a prescription. Journal Fam Pract. 2001 ;50(10);853-858.6. Linder JA, Singer DE. Desire for antibiotic prescribing for adults with upper respiratory tract infections. Journal of General Internal Medicine. 2003;18;795-801.7. Shapiro DJ, Hicks LA, Pavia AT, Hersh AL. Antibiotic prescribing for adults in ambulatory care in the USA, 2007-2009. Journal of Antimicrobial Chemotherapy. 2014;69;234-240.8. Nielson-Bohlman L, Panzer AM, Kindig DA, eds. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies Press; 2004:31-32.9. Kutner M, Greenberg E, Jin Y, Paulsen C. The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy. Washington, DC: National Center for Education Statistics; 2006.Disclosure StatementAuthors of this presentation have nothing to disclose concerning possible financial or personal relationships with commercial entities that may have a direct or indirect interest in the subject matter of this presentation.This project is funded by a grant from the Ambulatory Care Practice and Research Network of the American College of Clinical Pharmacy.

Literacy-Sensitive Approach to Improving Antibiotic Understanding in a Community-Based Setting

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Literacy-Sensitive Approach to Improving Antibiotic Understanding in a Community-Based Setting

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