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Knowledge, Attitudes and Intentions to Prescribe Antibiotics: A Structural Equation Modeling Study of Primary Care Institutions in Hubei, China

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  • Chenxi Liu

    (School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan 430030, China)

  • Chaojie Liu

    (School of Psychology and Public Health, La Trobe University, Melbourne, Victoria 3083, Australia)

  • Dan Wang

    (School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan 430030, China)

  • Xinping Zhang

    (School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan 430030, China)

Abstract

The aim of this paper is to measure the knowledge and attitudes of primary care physicians toward antibiotic prescriptions and their impacts on antibiotic prescribing. A questionnaire survey was conducted on 625 physicians from 67 primary care facilities in Hubei, China. Structural equation modelling (SEM) was applied to test the theoretical framework derived from the Knowledge, Attitudes, and Practices (KAP) theory. Physicians’ knowledge, five sub-types of attitudes, and three sub-types of behavioral intentions towards antibiotic use were measured. Physicians had limited knowledge about antibiotic prescriptions (average 54.55% correct answers to 11 questions). Although they were generally concerned about antibiotic resistance (mean = 1.28, SD = 0.43), and were reluctant to be submissive to pressures from consumer demands for antibiotics (mean = 1.29, SD = 0.65) and the requirements of defensive practice (mean = 1.11, SD = 0.63), there was a lack of motivation to change prescribing practices (mean = −0.29, SD = 0.70) and strong agreement that other stakeholders should take the responsibility (mean = −1.15, SD = 0.45). The SEM results showed that poor knowledge, unawareness of antibiotic resistance, and limited motivation to change contributed to physicians’ high antibiotics prescriptions ( p < 0.001). To curb antibiotic over-prescriptions, improving knowledge itself is not enough. The lack of motivation of physicians to change needs to be addressed through a systematic approach.

Suggested Citation

  • Chenxi Liu & Chaojie Liu & Dan Wang & Xinping Zhang, 2019. "Knowledge, Attitudes and Intentions to Prescribe Antibiotics: A Structural Equation Modeling Study of Primary Care Institutions in Hubei, China," IJERPH, MDPI, vol. 16(13), pages 1-16, July.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:13:p:2385-:d:245833
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    References listed on IDEAS

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    1. Ke Shen & Jian Yang, 2022. "Residents’ Support for Tourism Amidst the COVID-19 Era: An Application of Social Amplification of Risk Framework and Knowledge, Attitudes, and Practices Theory," IJERPH, MDPI, vol. 19(6), pages 1-17, March.
    2. Shanshan Guo & Wenchao Du & Shuqing Chen & Xitong Guo & Xiaofeng Ju, 2019. "Exploring the Impact of the Rational Antibiotic Use System on Hospital Performance: The Direct Effect and the Spillover Effect," IJERPH, MDPI, vol. 16(18), pages 1-13, September.

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