Factors affecting antibiotics consumption among the elderly population in Thailand

Authors

  • Dr. Worrayot Department of Social Medicine, Buriram Hospital
  • Prof. Wongsa Dean, Faculty of Public Health, Khon Kaen University
  • Asst. Prof. Dr. Roshan Faculty of Public Health, Khon Kaen University

DOI:

https://doi.org/10.62992/5v0kfs93

Keywords:

Antibiotic, Elderly, Transportation expense

Abstract

Background: The consumption of antibiotic among the elderly population has raised concerns in Thailand due to its correlation with antimicrobial resistance (AMR) infections. Moreover, it is also related to adverse drug reactions resulting from impaired drug excretion and elimination. Contributing factors to antibiotic consumption in the elderly population are insufficiently understood in Thailand.

Objectives: The purposes of this study were to determine the prevalence of antibiotic consumption behaviour among the elderly population and to identify associated factors.

Methods: A cross-sectional study was conducted using survey data from the National Statistic Office, which included only elderly individuals. Bivariate analysis with a generalized linear mixed model (GLMM) was performed to screen for significant independent variables with a significance level below 0.05. All significant variables were included in the multivariable analysis, which revealed adjusted odds ratios (AOR) and 95% confidence intervals (CI).                               

Results: Of 9,104 elderly people, the prevalence of antibiotic consumption was found to be 7.77% (95% CI: 7.21% - 8.31%). The multivariable GLMM analysis demonstrated that being free from underlying diseases (AOR= 2.16, 95% CI: 1.63-2.88, p-value < 0.001), having transportation expenses (AOR = 2.11, 95% CI:1.49-2.99, p-value < 0.001), experiencing pain and discomfort symptoms (AOR =1.66, 95%CI: 1.27-2.16, p-value < 0.001), having anxiety and depression (AOR = 1.66, 95%CI: 1.27-2.16, p-value = 0.012), having moderate to  poor level of knowledge (AOR = 2.42 95% CI: 1.55-3.78 and (AOR=2.71, 95% CI:1.75-4.21), and not  receiving information regarding antibiotic use and its resistance (AOR = 5.12, 95%CI: 4.12-6.36, p-value < 0.001) were the major contributing factors to antibiotic consumption behaviours in the elderly population.

Conclusion: The prevalence of antibiotic consumption in the elderly population may contribute to emergence of AMR infections and increased mortality rates. Implementing clinical practice guidelines and health education programs is essential to control antibiotic prescriptions and discourage self-medication in Thailand.   

References

Hlaing SMM, Clara N, Han AN. Factors influencing health service utilization among the elderly in Insein Township, Yangon Region. Makara Journal. 2020;24(3):208-15.

Esme M, Topeli A, Yavuz BB, Akova M. Infections in the Elderly Critically-Ill Patients. 2019;6.

Biedron C, Chopra T. Issues Surrounding Antibiotic Use in Older Adults. Current Translational Geriatrics and Experimental Gerontology Reports. 2013;2(3):151-8.

Scott MM, Liang SY. Infections in Older Adults. Emergency medicine clinics of North America. 2021;39(2):379-94.

Beckett CL, Harbarth S, Huttner B. Special considerations of antibiotic prescription in the geriatric population. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 2015;21(1):3-9.

Soraci L, Cherubini A, Paoletti L, Filippelli G, Luciani F, Laganà P, et al. Safety and Tolerability of Antimicrobial Agents in the Older Patient. Drugs & aging. 2023;40(6):499-526.

Christopher C, Kc B, Shrestha S, Blebil AQ, Alex D, Mohamed Ibrahim MI, et al. Medication use problems among older adults at a primary care: A narrative of literature review. Aging medicine (Milton (NSW)). 2022;5(2):126-37.

Cruz SP, Cebrino J. Prevalence and Determinants of Antibiotic Consumption in the Elderly during 2006-2017. Int J Environ Res Public Health. 2020;17(9).

Kusuma IY, Matuz M, Bordás R, Juhasz Haverinen M, Bahar MA, Hajdu E, et al. Antibiotic use in elderly patients in ambulatory care: A comparison between Hungary and Sweden. 2022;13.

YH OSBMMDLMG. Trends in outpatient antibiotic use and prescribing practice among US older adults,. BMJ. 2018;362:1-7.

Galimberti F, Casula M, Olmastroni E, Catapano AL, Tragni E, Group oboERD. Antibiotic Prescription in the Community-Dwelling Elderly Population in Lombardy, Italy: A Sub-Analysis of the EDU.RE.DRUG Study. 2022;11(10):1369.

Rodrigues LP, de Oliveira Rezende AT, Delpino FM, Mendonça CR, Noll M, Nunes BP, et al. Association between multimorbidity and hospitalization in older adults: systematic review and meta-analysis. Age and ageing. 2022;51(7).

Longman JM, I Rolfe M, Passey MD, Heathcote KE, Ewald DP, Dunn T, et al. Frequent hospital admission of older people with chronic disease: a cross-sectional survey with telephone follow-up and data linkage. BMC Health Services Research. 2012;12(1):373.

Lo ACY, Li JTS, Chau JPC, Wong SYS, Hui DSC, Lee VWY. Impact of interprofessional service-learning on the effectiveness of knowledge transfer of antimicrobial resistance to Hong Kong elders: a quasi-experiment. Antimicrobial Resistance & Infection Control. 2021;10(1):145.

Das S, Mitra K, Mandal M. Sample size calculation: Basic principles. Indian journal of anaesthesia. 2016;60(9):652-6.

Hayward GN, Moore A, McKelvie S, Lasserson DS, Croxson C. Antibiotic prescribing for the older adult: beliefs and practices in primary care. The Journal of antimicrobial chemotherapy. 2019;74(3):791-7.

Lin L, Sun R, Yao T, Zhou X, Harbarth S. Factors influencing inappropriate use of antibiotics in outpatient and community settings in China: a mixed-methods systematic review. BMJ global health. 2020;5(11).

Shallcross L, Rockenschaub P, Blackburn R, Nazareth I, Freemantle N, Hayward A. Antibiotic prescribing for lower UTI in elderly patients in primary care and risk of bloodstream infection: A cohort study using electronic health records in England. PLoS medicine. 2020;17(9):e1003336.

Fortin É, Deceuninck G, Sirois C, Quach C, Simard M, Dionne M, et al. Chronic diseases and compliance with provincial guidelines for outpatient antibiotic prescription in cases of otitis media and respiratory infections: a population-based study of linked data in Quebec, Canada, 2010-2017. CMAJ open. 2022;10(3):E841-e7.

Liang SY. Sepsis and Other Infectious Disease Emergencies in the Elderly. Emergency medicine clinics of North America. 2016;34(3):501-22.

Rajagopalan S. Serious infections in elderly patients with diabetes mellitus. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2005;40(7):990-6.

Carbon C. Optimal treatment strategies for community-acquired pneumonia: high-risk patients (geriatric and with comorbidity). Chemotherapy. 2001;47 Suppl 4:19-25; discussion 6-7.

Gharbi M, Drysdale JH, Lishman H, Goudie R, Molokhia M, Johnson AP, et al. Antibiotic management of urinary tract infection in elderly patients in primary care and its association with bloodstream infections and all cause mortality: population based cohort study. Bmj. 2019;364:l525.

Zhang T, Lin H, Zhao X, Wang W, Yan F, Lambert H. Influences on treatment-seeking and antibiotic use for common illnesses in eastern China. BMC Public Health. 2023;23(1):1849.

Dinan K, Dinan T. Antibiotics and mental health: The good, the bad and the ugly. Journal of internal medicine. 2022;292(6):858-69.

Lee J-W, Lee H, Kang H-Y. Association between depression and antibiotic use: analysis of population-based National Health Insurance claims data. BMC Psychiatry. 2021;21(1):536.

Prichett LM, Yolken RH, Wu L, Severance EG, Kumra T. Relationship between antibiotic exposure and subsequent mental health disorders in a primary care health system. Brain, behavior, & immunity - health. 2022;21:100430.

Moore A, McKelvie S, Glogowska M, Lasserson D, Hayward G. Infection in older adults: a qualitative study of patient experience. The British journal of general practice : the journal of the Royal College of General Practitioners. 2020;70(694):e312-e21.

Domenichiello AF, Ramsden CE. The silent epidemic of chronic pain in older adults. Progress in neuro-psychopharmacology & biological psychiatry. 2019;93:284-90.

Kong LS, Islahudin F, Muthupalaniappen L, Chong WW. Knowledge and Expectations on Antibiotic Use among Older Adults in Malaysia: A Cross-Sectional Survey. Geriatrics (Basel, Switzerland). 2019;4(4).

Office of the Permanent Secretary. Service Plan: Rational Drug Use. 1st ed. Nonthaburi. Ministry of Public Health; 2017.

Wilson J, Heinsch M, Betts D, Booth D, Kay-Lambkin F. Barriers and facilitators to the use of e-health by older adults: a scoping review. BMC Public Health. 2021;21(1):1556.

Turnbull SL, Dack C, Lei J, Aksu I, Grant S, Lasseter G, et al. Barriers and facilitators to use of digital health tools by healthcare practitioners and their patients, before and during the COVID-19 pandemic: a multimethods study. BMJ open. 2024;14(3):e080055.

Downloads

Published

17-09-2024

Issue

Section

Original Article

Categories

How to Cite

1.
Factors affecting antibiotics consumption among the elderly population in Thailand. IJPHAP [Internet]. 2024 Sep. 17 [cited 2024 Dec. 3];3(6):69-83. Available from: https://ijphap.com/index.php/home/article/view/87