Using the internet to educate the public about antimicrobial
resistance: a project from the UK’s National electronic Library of Infection
Educating and informing the public is an essential component
of any strategy for reducing the further development and spread of antimicrobial
resistance. Research has shown that doctors believe patient expectations play
a major role in inappropriate use of antibiotics (1). A number of influential
recent reports have emphasised the role of public education in reducing the
pressure on general practitioners to prescribe antibiotics (2, 3). Investigations
into the impact that community-wide campaigns and videotapes about antimicrobial
resistance have on prescribing patterns and patient expectations have shown
that they can reduce the expectation of antimicrobial prescribing (4). But
does the internet have the same impact on patient and public knowledge and
attitudes?
An antimicrobial resistance digital library (http://www.antibioticresistance.org.uk)
was developed as an interface for the public to information held in the
National electronic Library of Infection (NeLI, http://www.neli.org.uk/,
5). The NeLI is a specialist library of the United Kingdom National electronic
Library for Health (NeLH, http://www.nelh.nhs.uk)
and provides a freely accessible, online, evidence based, quality tagged
internet portal to the best available evidence on prevention, treatment
and investigation of infectious disease. Education of the public about antimicrobial
resistance is a key to tackling this global problem. Although the NeLI is
aimed at health professionals, it was considered important to provide an
access point for the public to evidence based information around antimicrobial
resistance. The aim of the site is to to inform the public of current evidence
based guidelines on antimicrobial prescribing and the issues surrounding
those guidelines in an effort to reduce patient pressure on doctors and
subsequently reduce inappropriate prescribing. The main content of the site
is found in over 60 frequently asked questions (FAQs), grouped into 22 categories.
These FAQs provide short evidence based answers, written by the NeLI team,
with links to the evidence and related questions on the site. The FAQs were
written using evidence based documents (3,4,6).
Each FAQ is indexed using MeSH
keywords to permit keyword searching. Each category is assigned a collection
of relevant external resources, all catalogued using the NeLI electronic
catalogue card. A short summary of the resource is provided to indicate
the target audience, content and level of quality. The site also provides
links to antimicrobial resistance stories in the general media.
We have conducted a number of research studies looking at the impact of
this website on user knowledge and attitudes. These studies have involved
the public, medical professionals and medical students. We are still continuing
this research and planning an online study in the near future, more information
on how to take part will be available from the website. The research involves
completing a questionnaire about antibiotics and their use in acute otitis
media, then looking through the website and completing the same questionnaire
again. These studies have shown very positive results with clear improvements
in the knowledge of users and decreased expectations of receiving antibiotics
for AOM following use of the website (7,8).
Although the site is currently only available in English, it will soon
be translated into Spanish, and the NeLI team are looking for opportunities
to enable translation into other European languages. The team has links
with the European Society of Clinical Microbiology and Infectious Diseases
(ESCMID, http://www.escmid.org)
and the Alliance for the Prudent Use of Antibiotics (APUA, http://www.tufts.edu/med/apua/)
and is keen to hear from anyone interested in this project from a European
perspective.