Year 2021
October 2021


Abstract Title
Patient Empowerment can increase Shared Decision Making on Antibiotic Therapy among inpatients



Tan Tock Seng Hospital1, National Centre for Infectious Diseases2 

Background & Hypothesis

In Singapore, half of hospitalized patients receive antibiotics. Patients are not engaged in antimicrobial stewardship efforts, although shared decision making (SDM) can improve health outcomes. We sought to understand the association between patient empowerment and their involvement in SDM on antibiotic therapy.


We conducted a cross-sectional survey on systematically-sampled inpatients on antibiotic therapy in Tan Tock Seng Hospital, 24 March–28 May 2021. The questionnaire included 7 items(5-point Likert scale) on involvement in SDM from SDM-Q-9(Kriston, 2012) and 10 items(4-point Likert scale) on patient empowerment(involvement in decisions, interactions with healthcare professionals, and degree of control) from HCEQ-10(Gagnon, 2006). A multivariable linear regression model was constructed to assess for independent associations between the 3 constructs of patient empowerment and involvement in SDM on antibiotic therapy.


Of 118 inpatients, mean age was 57.5±15.5 years, two-thirds were male (n=75,63.6%), and one-third (n=38,32.2%) had tertiary-level education. All 4 scales had good internal consistency(Cronbach’s alpha: 0.87–0.93). Mean scores for SDM(total: 35), involvement in decisions(total: 24), interactions(total: 32), and degree of control(total: 24) were 23.7±6.3, 16.4±4.2, 23.3±4.8, 16.8±4.8, respectively. After adjusting for age, gender, ethnicity, and educational level, involvement in decisions (β 0.64, 95%CI 0.31–0.96) and degree of control (β 0.43, 95%CI 0.07–0.62) were positively associated with involvement in SDM on antibiotic therapy. Interactions with healthcare professionals was not associated with SDM (β -0.21, 95%CI -0.52-0.10).

Discussion & Conclusion

Empowering inpatients with involvement in decisions and control of their hospital care can increase their involvement in SDM on antibiotic therapy, contributing to antimicrobial stewardship in hospitals.