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Nurses and doctors warning of antimicrobial resistance found ‘ineffective in film adverts’

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Evidence that the public are more likely to listen to animated characters than real clinicians on key messages around the use of antibiotics has sparked a new approach to campaigns by Public Health England.

A forthcoming public health campaign about antimicrobial resistance and the inappropriate use of antibiotics will not include adverts with nurses and doctors warning people about the drugs, because it was thought this approach may be ineffective.

“Putting doctors and nurses on televisions telling people not to take antibiotics was really not working”

 Paul Cosford

Experts on human behaviour found that the public would not change their actions if they were told by clinicians to reconsider their use of antibiotics, because those watching the film would likely believe the purpose of the advert was to help save the NHS money.

As a result, Public Health England, which is leading the national drive to reduce antimicrobial resistance, said it had decided not to use this type of advert for a forthcoming awareness campaign – though it had previously used the approach with its Antibiotic Guardian films.

Instead, the government arms-length body has developed a film that features animated antibiotic pills singing to a song about the dangers of resistance, due to be launched in October.

The advert is still in development, but an earlier version piloted in the spring shows the animated figures explaining that antibiotics cannot be used to treat colds and flu, and that if drugs are used wrongly they could in the future become ineffective when needed for more serious infections.

At PHE’s annual conference at the University of Warwick this week, PHE’s medical director Professor Paul Cosford said: “[Our] behaviour insights work has found that putting doctors and nurses on televisions telling people not to take antibiotics was really not working,” he said.

“It was seen as people in the system trying to tell people not to cost the system money,” he told delegates at the event in Coventry on Tuesday.

Public Health England

Dr Paul Cosford

Paul Cosford

“Whereas, if you look at the adverts now, they are about the pills themselves. They are ‘singing’ antibiotics. It seems to be remarkably effective,” he added.

In 2016, the UK government said it wanted to see inappropriate prescribing of antibiotics halved by 2020 in a bid to bring down resistance. 

It also wanted to see a 50% reduction in the number of drug-resistant bloodstream infections, such as E coli, among patients in hospital by 2020 to reduce the need for antibiotics.

The National Institute for Health and Care Excellence has also said in recent years that nurses should be able to question the antimicrobial prescribing practices of colleagues when they are not in line with guidelines.

Professor Cosford noted that there had been recent reductions in antibiotic prescribing in primary care over the past four years and, while secondary care services had seen an increase, this was mainly due to more specialist and targeted use of drugs.

“So this is a good start but much more to do there,” he told the audience of public health professionals.

As part of the presentation he gave on PHE’s work to tackle antimicrobial resistance, Professor Cosford noted a range of other actions that were required.

“Getting the right care for people with urinary catheters and infections in every care home all the time is a major challenge”

 Paul Cosford

Improving care provided to people with urinary catheters was needed, because around half of UK bloodstream infections originated from a urinary tract infection (UTI), he said. However, he acknowledged it was a “huge” challenge.

“If we go back to what are the issues of UTIs, then getting the right care for people with urinary catheters and infections in every care home in very part of the country all the time is a major challenge for us,” he said.

Meanwhile, attitudes to vaccines – which some members of the public believe to be “dangerous” – and the belief that “antibiotics cure anything” also needed to be addressed, he added.

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