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The impact of C-reactive protein testing on treatmentseeking behavior and patients’ attitudes toward their care in Myanmar and Thailand

Authors

Rachel C. Greer
rachel@tropmedres.ac
https://orcid.org/0000-0001-9327-0234
Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
Thomas Althaus
https://orcid.org/0000-0002-6997-3877
The Department of Health Action, Monaco, Monaco; Monaco Scientific Centre, Monaco, Monaco.
Sabine Dittrich
https://orcid.org/0000-0002-4522-2788
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; FIND, global alliance for diagnostic, Geneva, Switzerland; Deggendorf Institute of Technology, European- Campus Rottal Inn, Pfarrkirchen, Germany.
Christopher C. Butler
Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Phaik Yeong Cheah
https://orcid.org/0000-0001-6327-3266
Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
Tri Wangrangsimakul
https://orcid.org/0000-0003-0430-5699
Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
Frank M. Smithuis
https://orcid.org/0000-0002-4704-9915
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Medical Action Myanmar, Yangon, Myanmar.
Nicolas P.J. Day
Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, Thailand.
Yoel Lubell
https://orcid.org/0000-0002-0237-1070
Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, Thailand.

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’ treatmentseeking behavior before and during the twoweek 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.

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How to Cite

Greer, R. C., Althaus, T., Dittrich, S., Butler, C. C., Cheah, P. Y., Wangrangsimakul, T., Smithuis, F. M., Day, N. P., & Lubell, Y. (2023). The impact of C-reactive protein testing on treatmentseeking behavior and patients’ attitudes toward their care in Myanmar and Thailand. Healthcare in Low-Resource Settings, 11(1). https://doi.org/10.4081/hls.2023.11278
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