New European Patient Forum Paper Highlights AMR Challenges

The European Patient Forum (EPF) recently released a policy paper on antimicrobial resistance (AMR) to improve the understanding of how AMR affects patients and how the patient community can work together to build effective solutions.

The EPF paper is part of a greater effort by European organizations, such as the European Centre for Disease Prevention and Control (ECDC), to reduce the spread of AMR by highlighting the cost of resistant infections and how members of the community can help.

AMR occurs when bacteria, viruses, fungi, and parasites stop responding to antimicrobial drugs. The phenomenon poses a significant health risk, including disease spread, severe illness, disability, and death.

The EU Council adopted a non–legally binding recommendation to increase action against AMR in June 2023. However, the ECDC noted that the European Union currently is behind target.

Although some progress has been made (the European Union met targets for methicillin-resistant Staphylococcus aureus bloodstream infections by 2023), some areas continue to lag. The incidence of carbapenem-resistant Klebsiella pneumoniae bloodstream infections, for example, increased by over 50% from 2019, despite a 5% reduction target by 2030.

Infections caused by antimicrobial-resistant organisms remain common in the EU/European Economic Area countries, where they account for over 1 in 5 bacterial infections, according to a 2023 Organisation for Economic Co-operation and Development (OECD) report. That report also noted that AMR costs Europe €11.7 billion a year when adjusted for purchasing power parity.

The World Health Organization (WHO) meanwhile reported that AMR is directly responsible for 133,000 deaths each year in the WHO European Region and was indirectly linked to 541,000 deaths.

“Ninety percent of total human consumption of antibiotics takes place in the community sector, or outpatient setting,” Dominique Monnet, the ECDC head of section for AMR and healthcare-associated infections, told Medscape Medical News. “To improve progress toward the EU targets on antimicrobial consumption, it is therefore essential to address unnecessary use of antibiotics in the community, in particular in situations where antibiotics are not needed.”

The EPF’s policy paper highlighted three main areas for addressing AMR: Improving communication, enhancing patient and public health literacy, and amplifying patient voices.

Communicating to the Public

Using the correct terminology is key for communicating information about AMR to the public, suggested the EPF in its policy paper. Research shows that the term “antimicrobial resistance” is neither memorable nor helpful in establishing risk association, and that alternatives could include “antibiotic resistance” and “drug-resistant infections.”

The paper further noted that warlike words such as “fight,” “struggle,” and “defeat” should be avoided in favor of terms such as “building,” “together,” and “prevention.” Meanwhile, an EPF spokesperson told Medscape Medical News that adding personal stories enhances relatability and creates a more compelling narrative.

“It’s essential to understand audience behavior and tailor messages to align with their communication styles, addressing cognitive biases and misconceptions,” the spokesperson said. “Using behavior-change models can help structure campaigns that effectively promote behavioral shifts, shedding light on the factors that influence individual decision-making.”

“Moreover, the research in this area indicates the importance of actively engaging communities in the design and implementation of campaigns, as this generates greater cultural relevance and impact,” they added.

Enhancing Public Health Literacy

The paper noted that key challenges include balancing what may appear as conflicting messages, such as reducing the consumption of antimicrobials, while ensuring people take their medication as prescribed.

The EPF also recommended increasing understanding on what types of infections require antibiotics, practicing hand and general hygiene, vaccination, and rapid diagnostic tests to optimize treatment. The patient-doctor relationship was further highlighted as key for improving patient and public health literacy.

“Shared decision-making, listening, effective communication, and empathy have all been shown to improve patients’ adherence to treatment and health literacy,” the EPF wrote. “Patients share their circumstances, concerns, and preferences; doctors share the possible treatment options with their benefits and harms.”

The policy paper also highlighted the crucial role played by patient communities in creating political momentum and drawing attention to the AIDS epidemic and burden of cancer. Given some estimates state that deaths from AMR could outstrip cancer deaths by 2050 if measures aren’t taken promptly, the EPF said that the time to act is now.

Raising Awareness Key

Patient organizations play a key role in raising awareness of AMR by educating the public, advocating for safe healthcare, ensuring access to effective treatments, and urging policymakers to adopt strong AMR policies, according to the EPF spokesperson.

While the benefits of such groups are clear, funding remains a key limitation.

“Many patient organizations are interested in AMR, but they often lack the resources to engage,” the spokesperson said. “We therefore believe that funding capacity-building programs for patient organizations is essential for improving public health literacy of AMR and is one of the keys to solving the problem of AMR.”

The OECD report highlighted the need for targeted policies to reduce the impact of AMR and noncommunicable diseases and emphasized that public awareness campaigns have a “significant role to play” by encouraging healthier lifestyles, preventive care, and responsible antibiotic use.

Monnet noted, “According to Eurobarometer surveys, the percentage of Europeans who know that antibiotics are not effective against cold and flu increased from 46% in 2009 to 66% in 2018. During the same period, the percentage of Europeans who said that they took antibiotics during the past year decreased from 40% to 32%.”

“In view of the latest antimicrobial consumption surveillance data, we now need to give a new boost to these awareness campaigns, at EU level and at national level,” she added.

The EPF has published multiple resources on its website to help raise awareness about AMR. They have also launched a ready-to-use social media toolkit for its member organizations participating in the #UnderstandingAMR campaign, which took place in November last year.

Annie Lennon is a medical journalist. Her writing appears on Medscape Medical News, Medical News Today, and Psych Central, among other outlets.