Knowledge, attitudes, motivations and expectations regarding antimicrobial use amongst community members seeking care at the primary health care level : a scoping review protocol

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Ramdas, Nishana and Meyer, Johanna C. and Schellack, Natalie and Godman, Brian and Turawa, Eunice and Campbell, Stephen M. (2025) Knowledge, attitudes, motivations and expectations regarding antimicrobial use amongst community members seeking care at the primary health care level : a scoping review protocol. BMJ Open. ISSN 2044-6055 (In Press)

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Abstract

Introduction: Inappropriate antibiotic use in (PHC) settings fuels antimicrobial resistance (AMR), threatens patient safety and burdens healthcare systems. Patients' knowledge, attitudes, motivations, and expectations play a crucial role in antibiotic use behavior especially in low- and middle-income countries including South Africa. There is a need to ensure measures of antibiotic use, interventions and future guidance reflect cultural, community and demographic issues associated with patient views to reduce inappropriate use of antibiotics and associated AMR. The objective of this scoping review is to identify key themes surrounding knowledge, attitudes, motivations, and expectations amongst patients and community members regarding antimicrobial use in PHC settings especially in low- and middle-income countries. Methods and analysis: This scoping review employs a comprehensive search strategy across multiple electronic databases, including OVID, Medline, PubMed, and CINHAL, to identify studies addressing patients or community members seeking care at primary health care facilities and exploring key drivers of antimicrobial use. The Covidence web-based platform will be used for literature screening and data extraction and the Critical Appraisal Skills Programme qualitative checklist will assess the quality of qualitative papers. Anticipated results will provide an overview of the current evidence base, enabling identification of knowledge gaps. A narrative synthesis of findings will summarize key themes and patterns in patients' knowledge, attitudes, motivations, and expectations related to antibiotic use across studies, while considering methodological diversity and limitations.

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