A blog from the Centre for Research Ethics & Bioethics (CRB)

Tag: antibiotic resistance

Two new dissertations!

Two of our doctoral students at CRB recently successfully defended their dissertations. Both dissertations reflect a trend in bioethics from purely theoretical studies to also include empirical studies of people’s perceptions of bioethical issues.

Åsa Grauman’s dissertation explores the public’s view of risk information about cardiovascular disease. The risk of cardiovascular disease depends on many factors, both lifestyle and heredity influence the risk. Many find it difficult to understand such risk information and many underestimate their risk, while others worry unnecessarily. For risk information to make sense to people, it must be designed so that recipients can benefit from it in practice. That requires knowing more about their perspective on risk, how health information affects them, and what they think is important and unimportant when it comes to risk information about cardiovascular disease. One of Åsa Grauman’s conclusions from her studies of these issues is that people often estimate their risk on the basis of self-assessed health and family history. As this can lead to the risk being underestimated, she argues that health examinations are important which can nuance individuals’ risk assessments and draw their attention to risk factors that they themselves can influence.

If you want more conclusions and see the studies behind them, read Åsa Grauman’s dissertation: The publics’ perspective on cardiovascular risk information: Implications for practice.

Mirko Ancillotti’s dissertation explores the Swedish public’s view of antibiotic resistance and our responsibility to reduce its prevalence. The rise of antibiotic-resistant bacteria is one of the major global threats to public health. The increase is related to our often careless overuse of antibiotics in society. The problem needs to be addressed both nationally and internationally, both collectively and individually. Mirko Ancillotti focuses on our individual responsibility for antibiotic resistance. He examines how such a responsibility can be supported through more effective health communication and improved institutional conditions that can help people to use antibiotics more judiciously. Such support requires knowledge of the public’s beliefs, values ​​and preferences regarding antibiotics, which may affect their willingness and ability to take responsibility for their own use of antibiotics. One of the studies in the dissertation indicates that people are prepared to make significant sacrifices to reduce their contribution to antibiotic resistance.

If you want to know more about the Swedish public’s view of antibiotic resistance and the possibility of supporting judicious behaviour, read Mirko Ancillotti’s dissertation: Antibiotic Resistance: A Multimethod Investigation of Individual Responsibility and Behaviour.

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

Åsa Grauman. 2021. The publics’ perspective on cardiovascular risk information: Implications for practice. Uppsala: Acta Universitatis Upsaliensis.

Mirko Ancillotti. 2021. Antibiotic Resistance: A Multimethod Investigation of Individual Responsibility and Behaviour. Uppsala: Acta Universitatis Upsaliensis.

This post in Swedish

Ethics needs empirical input

People care about antibiotic resistance

The rise of antibiotic-resistant bacteria is a global threat to public health. In Europe alone, antibiotic resistance (AR) causes around 33,000 deaths each year and burdens healthcare costs by around € 1.5 billion. What then causes AR? Mainly our misuse and overuse of antibiotics. Therefore, in order to reduce AR, we must reduce the use of antibiotics.

Several factors drive the prescribing of antibiotics. Patients can contribute to increased prescriptions by expecting antibiotics when they visit the physician. Physicians, in turn, can contribute by assuming that their patients expect antibiotics.

In an article in the International Journal of Antimicrobial Agents, Mirko Ancillotti from CRB presents what might be the first study of its kind on the public’s attitude to AR when choosing between antibiotic treatments. In a so-called Discrete Choice Experiment, participants from the Swedish public were asked to choose between two treatments. The choice situation was repeated several times while five attributes of the treatments varied: (1) the treatment’s contribution to AR, (2) cost, (3) risk of side effects, (4) risk of failed treatment effect, and (5) treatment duration. In this way, one got an idea of ​​which attributes drive the use of antibiotics. One also got an idea of ​​how much people care about AR when choosing antibiotics, relative to other attributes of the treatments.

It turned out that all five attributes influenced the participants’ choice of treatment. It also turned out that for the majority, AR was the most important attribute. People thus care about AR and are willing to pay more to get a treatment that causes less antibiotic resistance. (Note that participants were informed that antibiotic resistance is a collective threat rather than a problem for the individual.)

Because people care about antibiotic resistance when given the opportunity to consider it, Mirko Ancillotti suggests that a path to reducing antibiotic use may be better information in healthcare and other contexts, emphasizing our individual responsibility for the collective threat. People who understand their responsibility for AR may be less pushy when they see a physician. This can also influence physicians to change their assumptions about patients’ expectations regarding antibiotics.

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

M. Ancillotti, S. Eriksson, D.I. Andersson, T. Godskesen, J. Nihlén Fahlquist, J. Veldwijk, Preferences regarding antibiotic treatment and the role of antibiotic resistance: A discrete choice experiment, International Journal of Antimicrobial Agents, Volume 56, Issue 6, 2020. doi.org/10.1016/j.ijantimicag.2020.106198

This post in Swedish

Exploring preferences