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. 2023 Jul 6;11(1):11278.
doi: 10.4081/hls.2023.11278.

The impact of C-reactive protein testing on treatment-seeking behavior and patients' attitudes toward their care in Myanmar and Thailand

Rachel C Greer  1   2 , Thomas Althaus  3   4 , Sabine Dittrich  2   5   6 , Christopher C Butler  7 , Phaik Yeong Cheah  1   2   8 , Tri Wangrangsimakul  1   2 , Frank M Smithuis  2   9   10 , Nicolas P J Day  1   2 , Yoel Lubell  1   2
Affiliations

The impact of C-reactive protein testing on treatment-seeking behavior and patients' attitudes toward their care in Myanmar and Thailand

Rachel C Greer et al. Healthc Low Resour Settings. .

Abstract

C-reactive protein (CRP) point-of-care testing can reduce antibiotic prescribing in primary care patients with febrile and respiratory illness, yet little is known about its effects on treatment-seeking behavior. If patients go on to source antibiotics elsewhere, the impact of CRP testing will be limited. A randomized controlled trial assessed the impact of CRP testing on antibiotic prescriptions in Myanmar and Thai primary care patients with a febrile illness. Here we report patients' treatment-seeking behavior before and during the two-week study period. Self-reported antibiotic use is compared against urine antibacterial activity. Patients' opinions towards CRP testing were evaluated. Antibiotic use before study enrolment was reported by 5.4% while antimicrobial activity was detected in 20.8% of samples tested. During the study period, 14.8% of the patients sought additional healthcare, and 4.3% sourced their own antibiotics. Neither were affected by CRP testing. Overall, patients' satisfaction with their care and CRP testing was high. CRP testing did not affect patients' treatment-seeking behavior during the study period whilst modestly reducing antibiotic prescriptions. CRP testing appears to be acceptable to patients and their caregivers.

Keywords: AMR; C reactive protein; antibiotics; healthcare-seeking behaviour; point of care testing.

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Conflict of interest statement

Conflict of interests: SD was employed by FIND the global alliance for diagnostics during the study period. The other authors declare no conflict of interest; all authors confirm accuracy.

Figures

Figure 1
Figure 1
Venn diagrams to show day 0 and day 5 urine antibacterial activity and reported antibiotic use. Adapted from Greer 2022.
See this image and copyright information in PMC

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