Outcomes of the Antibiotics Smart Use Project: a Pilot Study in Saraburi Province - ผลของโครงการใช้ยาปฏิชีวนะอย่างสมเหตุผล: การนำร่องที่จังหวัดสระบุรี

Abstract

          The Antibiotics Smart Use Project (ASU) in Saraburi province was a pilot study and aimed at developing a model to reduce use of antibiotics in upper respiratory tract infections, acute diarrhea, and simple wounds as prescribed by healthcare providers in community hospitals and health centers. The PRECEDE-PROCEED planning model was used as a conceptual framework. This quasiexperimental study was designed to evaluate the project outcomes which were (1) antibiotic prescribing viewpoints and behavior of health professionals and (2) patients’ health status and satisfaction of those not receiving antibiotics. Data were collected from all 10 community hospitals and 87 health centers between December 2006 and May 2008. The results showed that a total of 315 healthcare professionals who attended and responded to the pre-test and post-test questionnaires had better knowledge regarding the target diseases and treatment, higher self-efficacy and stronger intention for not prescribing antibiotics (p < 0.001). After the project implementation, the total amount of antibiotics prescribed for outpatients decreased 18-46 percent. The percentage of outpatients with targeted diseases who did not receive antibiotics increased significantly from 45.5 to 74.7 (p < 0.001) whereas that of the control group did not change significantly. Almost all of 1,200 outpatients who did not receive antibiotics (97.1%) fully recovered from their illness or felt better, and approximately 90 percent were satisfied with the treatment outcomes. In conclusion, the ASU project achieved its goals. Currently, this project has not only been expanded to many provinces via networking collaborations, but has been also demonstrated feasibility to bridge local practice and national policy to promote continuity of rational antibiotics use.

Key words: Antibiotics Smart Use, antibiotic, antimicrobial, PRECEDE-PROCEED planning model, prescribing behavior, rational use of medicines