The role of behavioural science in combatting antimicrobial resistance

Abstract

Background - Antimicrobial resistance (AMR) is a serious and increasing problem worldwide, which is driven to a major extent by behaviours such as inappropriate use and prescribing of antibiotics. Method - A research programme carried out within the interdisciplinary Health Protection Research Unit in Evaluation of Interventions uses the Behaviour Change Wheel and the Medical Research Council guidance for complex interventions as frameworks to change AMR relevant behaviours at different levels of the health care setting. As a starting point, a behavioural analysis identifies key behaviours and associated facilitators and barriers. This forms the basis for selecting intervention strategies and proposing hypotheses about their mechanisms of action. Findings - The following projects will be used to illustrate the different steps of applying behavioural science to designing and evaluating AMR interventions: (1) Identifying key influences on antibiotic consumption and prescribing in community and clinical settings in rural China; (2) Developing and evaluating a parent-targeted online intervention to reduce unnecessary primary care visits and antibiotic prescribing for paediatric respiratory tract infections; (3) Investigating barriers to and facilitators of implementing a toolkit for the early detection, management and control of Carbapenemase-producing Enterobacteriaceae in an acute hospital setting. Discussion - Changing the behaviour of patients, health care professionals and organisations is a key component of combatting AMR and can be promoted through interdisciplinary collaborations drawing on behavioural science evidence and theory.