In the literature
Frey E, Kedrowicz A, Hedgpeth MW. Exploring companion animal caretakers’ attitudes, perceptions and behavioural drivers of antimicrobial use within the social context of veterinary care. J Small Anim Pract. 2022;63(12):873-881. doi:10.1111/jsap.13549
The Research …
Antimicrobial stewardship is imperative, especially with rising levels of antimicrobial resistance in animals and humans, but clinicians may feel pressure (eg, fear of losing clients, missing an infection) to prescribe antimicrobials outside established guidelines.
This study sought to understand cat and dog owner attitudes, perceptions, and drivers of antimicrobial use by examining results of online focus groups comprising pet owners (n = 26) in North Carolina who had administered antimicrobials to their pets for disease and/or prophylactic reasons. Discussion transcriptions were grouped into 5 themes: trust-building/relationships, shared decision-making/empowerment, clear communication, judicious antimicrobial use, and concerns surrounding antimicrobial use.
Owners indicated they rely on clinician expertise regarding antimicrobial use decisions; however, a strong relationship with the clinician was key for willingness to trust and follow recommendations. Clinician ability to listen and answer questions without appearing rushed was crucial for building trust.
Most owners stated they were amenable to watchful waiting or delayed prescribing when recommended, but some expressed concern over possible deterioration in their pets’ condition during this period. Including owners in active participation during treatment planning (eg, explaining why antimicrobials were or were not prescribed, establishing clear next steps and a plan for follow-up communication with the clinic) helped alleviate these concerns.
Most owners described antimicrobial administration as challenging and expressed concerns about adverse effects and antimicrobial resistance.
This study provides evidence that owners trust clinician decisions and are interested in helping make treatment plans for their pets. Clear explanations of antimicrobial use decisions are essential for compliance.
… The Takeaways
Key pearls to put into practice:
Pet owners should be active participants in treatment planning. Discussions should include rationale for using antimicrobials, how and when antimicrobials should be given, signs of deterioration or complications, and when to next contact the clinic. It is also important to reserve time to answer questions.
Some owners may expect antimicrobials that are not required. That expectation should be acknowledged, clinical decisions should be explained, and clear explanations regarding how the treatment plan will improve perceived pain or discomfort should be provided. A handout explaining why antibiotics were not prescribed can provide additional support (see Suggested Reading).
A concern for most participants in this study was difficulty administering antimicrobials. Antimicrobial administration is often challenging, particularly in cats. When antimicrobial therapy is deemed necessary, prescribing formulations that are easy to administer should be considered. Administration should be demonstrated and/or links provided to online videos for additional assistance.
Building relationships of trust with pet owners can take time and effort. Continuity of care should be prioritized when possible to build on previous interactions.