Preparing parents to make an informed choice about antibiotic use for common acute respiratory infections in children: A randomised trial of brief decision aids in a hypothetical scenario

Research output: Contribution to journalArticleResearchpeer-review

5 Citations (Scopus)

Abstract

BACKGROUND

Childhood acute respiratory infections (ARIs) are one of the most common reasons for primary care consultations and for receiving an antibiotic. Public awareness of antibiotic benefit and harms for these conditions is low. To facilitate informed decision making, ideally in collaboration with their doctor, parents need clear communication about benefits and harms. Decision aids may be able to facilitate this process.

OBJECTIVE

The aim of this study was to evaluate the effectiveness of three decision aids about antibiotic use for common ARIs in children.

METHODS

Adult parents of children aged 1-16 years (n = 120) were recruited from community settings and then randomised using a computer-generated randomisation sequence to receive a decision aid (n = 60) or fact sheet (n = 60). Allocation was concealed and used sealed and opaque sequentially numbered envelopes. Participants self-completed questionnaires at baseline and immediately post-intervention. The primary outcome was informed choice (conceptual and numerical knowledge; attitudes towards, and intention to use, antibiotics for a future ARI). Secondary outcomes were decisional conflict, decisional self-efficacy, and material acceptability.

RESULTS

After reading the information, significantly more intervention group participants made an informed choice [57%] compared with control group participants [29%] [difference 28, 95% confidence interval (CI) 11-45%, p < 0.01], and had higher total knowledge [mean difference (MD) 2.8, 95% CI 2.2-3.5, p < 0.01], conceptual knowledge (MD 0.7, 95% CI 0.4-1.1, p < 0.01) and numerical knowledge (MD 2.1, 95% CI 1.6-2.5, p < 0.01). Between-group differences in attitudes or intention to use antibiotics were not significant. Most intervention group participants found the information understandable and liked the aids' format and features.

CONCLUSION

The decision aids prepared parents to make an informed choice about antibiotic use more than fact sheets, in a hypothetical situation. Their effect within a consultation needs to be evaluated. Clinical Trials Registration Number: ACTRN12615000843550.

Original languageEnglish
Pages (from-to)463-474
Number of pages15
JournalThe Patient: Patient Centered Outcomes Research
Volume10
Issue number4
DOIs
Publication statusE-pub ahead of print - 4 Mar 2017

Fingerprint

Decision Support Techniques
Respiratory Tract Infections
Parents
Anti-Bacterial Agents
Confidence Intervals
Referral and Consultation
Self Efficacy
Random Allocation
Reading
Primary Health Care
Decision Making
Communication
Clinical Trials
Control Groups

Cite this

@article{f68b8aced3ab49119e038bdd7b3c79f1,
title = "Preparing parents to make an informed choice about antibiotic use for common acute respiratory infections in children: A randomised trial of brief decision aids in a hypothetical scenario",
abstract = "BACKGROUNDChildhood acute respiratory infections (ARIs) are one of the most common reasons for primary care consultations and for receiving an antibiotic. Public awareness of antibiotic benefit and harms for these conditions is low. To facilitate informed decision making, ideally in collaboration with their doctor, parents need clear communication about benefits and harms. Decision aids may be able to facilitate this process.OBJECTIVEThe aim of this study was to evaluate the effectiveness of three decision aids about antibiotic use for common ARIs in children.METHODSAdult parents of children aged 1-16 years (n = 120) were recruited from community settings and then randomised using a computer-generated randomisation sequence to receive a decision aid (n = 60) or fact sheet (n = 60). Allocation was concealed and used sealed and opaque sequentially numbered envelopes. Participants self-completed questionnaires at baseline and immediately post-intervention. The primary outcome was informed choice (conceptual and numerical knowledge; attitudes towards, and intention to use, antibiotics for a future ARI). Secondary outcomes were decisional conflict, decisional self-efficacy, and material acceptability.RESULTSAfter reading the information, significantly more intervention group participants made an informed choice [57{\%}] compared with control group participants [29{\%}] [difference 28, 95{\%} confidence interval (CI) 11-45{\%}, p < 0.01], and had higher total knowledge [mean difference (MD) 2.8, 95{\%} CI 2.2-3.5, p < 0.01], conceptual knowledge (MD 0.7, 95{\%} CI 0.4-1.1, p < 0.01) and numerical knowledge (MD 2.1, 95{\%} CI 1.6-2.5, p < 0.01). Between-group differences in attitudes or intention to use antibiotics were not significant. Most intervention group participants found the information understandable and liked the aids' format and features.CONCLUSIONThe decision aids prepared parents to make an informed choice about antibiotic use more than fact sheets, in a hypothetical situation. Their effect within a consultation needs to be evaluated. Clinical Trials Registration Number: ACTRN12615000843550.",
author = "Coxeter, {Peter D} and {Del Mar}, {Chris B} and Hoffmann, {Tammy C}",
year = "2017",
month = "3",
day = "4",
doi = "10.1007/s40271-017-0223-2",
language = "English",
volume = "10",
pages = "463--474",
journal = "Patient",
issn = "1178-1653",
publisher = "Springer Science + Business Media",
number = "4",

}

TY - JOUR

T1 - Preparing parents to make an informed choice about antibiotic use for common acute respiratory infections in children

T2 - A randomised trial of brief decision aids in a hypothetical scenario

AU - Coxeter, Peter D

AU - Del Mar, Chris B

AU - Hoffmann, Tammy C

PY - 2017/3/4

Y1 - 2017/3/4

N2 - BACKGROUNDChildhood acute respiratory infections (ARIs) are one of the most common reasons for primary care consultations and for receiving an antibiotic. Public awareness of antibiotic benefit and harms for these conditions is low. To facilitate informed decision making, ideally in collaboration with their doctor, parents need clear communication about benefits and harms. Decision aids may be able to facilitate this process.OBJECTIVEThe aim of this study was to evaluate the effectiveness of three decision aids about antibiotic use for common ARIs in children.METHODSAdult parents of children aged 1-16 years (n = 120) were recruited from community settings and then randomised using a computer-generated randomisation sequence to receive a decision aid (n = 60) or fact sheet (n = 60). Allocation was concealed and used sealed and opaque sequentially numbered envelopes. Participants self-completed questionnaires at baseline and immediately post-intervention. The primary outcome was informed choice (conceptual and numerical knowledge; attitudes towards, and intention to use, antibiotics for a future ARI). Secondary outcomes were decisional conflict, decisional self-efficacy, and material acceptability.RESULTSAfter reading the information, significantly more intervention group participants made an informed choice [57%] compared with control group participants [29%] [difference 28, 95% confidence interval (CI) 11-45%, p < 0.01], and had higher total knowledge [mean difference (MD) 2.8, 95% CI 2.2-3.5, p < 0.01], conceptual knowledge (MD 0.7, 95% CI 0.4-1.1, p < 0.01) and numerical knowledge (MD 2.1, 95% CI 1.6-2.5, p < 0.01). Between-group differences in attitudes or intention to use antibiotics were not significant. Most intervention group participants found the information understandable and liked the aids' format and features.CONCLUSIONThe decision aids prepared parents to make an informed choice about antibiotic use more than fact sheets, in a hypothetical situation. Their effect within a consultation needs to be evaluated. Clinical Trials Registration Number: ACTRN12615000843550.

AB - BACKGROUNDChildhood acute respiratory infections (ARIs) are one of the most common reasons for primary care consultations and for receiving an antibiotic. Public awareness of antibiotic benefit and harms for these conditions is low. To facilitate informed decision making, ideally in collaboration with their doctor, parents need clear communication about benefits and harms. Decision aids may be able to facilitate this process.OBJECTIVEThe aim of this study was to evaluate the effectiveness of three decision aids about antibiotic use for common ARIs in children.METHODSAdult parents of children aged 1-16 years (n = 120) were recruited from community settings and then randomised using a computer-generated randomisation sequence to receive a decision aid (n = 60) or fact sheet (n = 60). Allocation was concealed and used sealed and opaque sequentially numbered envelopes. Participants self-completed questionnaires at baseline and immediately post-intervention. The primary outcome was informed choice (conceptual and numerical knowledge; attitudes towards, and intention to use, antibiotics for a future ARI). Secondary outcomes were decisional conflict, decisional self-efficacy, and material acceptability.RESULTSAfter reading the information, significantly more intervention group participants made an informed choice [57%] compared with control group participants [29%] [difference 28, 95% confidence interval (CI) 11-45%, p < 0.01], and had higher total knowledge [mean difference (MD) 2.8, 95% CI 2.2-3.5, p < 0.01], conceptual knowledge (MD 0.7, 95% CI 0.4-1.1, p < 0.01) and numerical knowledge (MD 2.1, 95% CI 1.6-2.5, p < 0.01). Between-group differences in attitudes or intention to use antibiotics were not significant. Most intervention group participants found the information understandable and liked the aids' format and features.CONCLUSIONThe decision aids prepared parents to make an informed choice about antibiotic use more than fact sheets, in a hypothetical situation. Their effect within a consultation needs to be evaluated. Clinical Trials Registration Number: ACTRN12615000843550.

U2 - 10.1007/s40271-017-0223-2

DO - 10.1007/s40271-017-0223-2

M3 - Article

VL - 10

SP - 463

EP - 474

JO - Patient

JF - Patient

SN - 1178-1653

IS - 4

ER -