Healthcare in Low-resource Settings (Jul 2023)

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

  • Rachel C. Greer,
  • Thomas Althaus,
  • Sabine Dittrich,
  • Christopher C. Butler,
  • Phaik Yeong Cheah,
  • Tri Wangrangsimakul,
  • Frank M. Smithuis,
  • Nicolas P.J. Day,
  • Yoel Lubell

DOI
https://doi.org/10.4081/hls.2023.11278
Journal volume & issue
Vol. 11, no. 1

Abstract

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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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