149 - Unmet Informational Needs among Nursing Home Residents Receiving Antibiotics: A Qualitative Study

Background: Antibiotics are commonly used in the nursing home (NH) setting and increase residents’ risk for opportunistic and painful infections. Existing evidence of NH residents’ experiences and attitudes towards antibiotic use is limited. We aimed to explore NH residents’ experiences and perceptions of the benefits and risks to antibiotic treatment.

Methods: Two researchers conducted one-on-one semi-structured interviews with residents residing in a large not-for-profit NH in New York City. Interviews were audio-recorded and transcribed verbatim. Researchers coded the transcripts using thematic analysis in NVivo 12.

Results: A total of 26 residents engaged in individual interviews. Participants had a mean age of 76. Most were white (81%), female (58%) and had attended college (58%). Four thematic findings emerged: 1) participants’ involvement in antibiotic treatment decisions; 2) perceived benefits and risks to antibiotics; 3) unmet informational needs; and 4) suggestions to overcome informational needs. Participants described varied involvement in antibiotic treatment decisions, in which some participants described insisting antibiotics from their clinicians and others described leaving antibiotic treatment decisions entirely to the judgement of clinicians. Benefits of antibiotics were well-articulated, yet risks (side effects including antibiotic resistance) to antibiotics were poorly described. Participants reported unmet information needs, including concerns regarding potential drug interactions. Information needs were described to result from a lack of communication with NH staff and/or poor memory among NH residents. Participants suggested that NH residents receive written material regarding their antibiotic prescriptions and provided the types of information that would be helpful for NH residents to know.  Descriptions of themes and representative quotes are provided in Figure.Table. Thematic Findings and Representative Quotes


Conclusion: NH residents expressed a lack of understanding of risks to antibiotic use, unmet informational needs regarding their antibiotic treatments and articulated suggestions to address these information needs.