Evidence mapPaperPMID 41327097Full record

Trial reportBMC infectious diseases2025

Packaging-based visual-storytelling nudge to improve antibiotic adherence in uncomplicated urinary tract infection: a pilot randomized trial in Pakistan.

Iltaf Hussain, Sen Xu, Yi Dong, Muhammad Fawad Rasool, Jamshid Ullah, Amjad Khan, Muhtar Kadirhaz, Miaomiao Xu, Chengzhou Tang, Wei Zhao and 3 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

13 authors.

Iltaf Hussain *Department of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.
Sen Xu *Department of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.
Yi DongDepartment of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.
Muhammad Fawad RasoolDepartment of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakeriya University, Multan, Pakistan.
Jamshid UllahDepartment of Medical Laboratory Technology, Institute of Paramedical Sciences, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, Pakistan.
Amjad KhanDepartment of Pharmacy, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
Muhtar KadirhazDepartment of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.
Miaomiao XuDepartment of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.
Chengzhou TangDepartment of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.
Wei ZhaoDepartment of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.
Faiz Ullah KhanDepartment of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University Health Science Center, Peking University, Beijing, China.
Jie ChangDepartment of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China. jiechang@xjtu.edu.cn.
Yu FangDepartment of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China. yufang@xjtu.edu.cn.

Funding

National Natural Science Foundation of China 72274150
6 · The paper itself

Abstract

backgroundAntibiotic resistance (ABR) is a growing public health issue, where non-adherence to antibiotics accelerates the development of resistance. Packaging-based nudge interventions may offer a low-cost and scalable solution. This pilot randomized controlled trial (RCT) assessed the feasibility of a visual storytelling sticker affixed to antibiotic packaging to improve antibiotic adherence in patients with uncomplicated urinary tract infections (UTIs).

methodsA parallel two-arm pilot RCT was conducted across six tertiary-care hospitals between May and July 2025. Physician-confirmed uncomplicated UTI patients, prescribed with oral antibiotics, were randomized in a 1:1 manner to receive either antibiotics with a visual storytelling sticker (intervention) or standard care (control). Primary outcomes were feasibility metrics, including recruitment, retention, and intervention delivery fidelity. Antibiotic adherence, measured by pill count at the completion of treatment, was assessed as an exploratory outcome.

resultsOf the 120 patients approached, 114 were screened, and 84 were deemed eligible. Seventy patients consented, of whom 66 were randomized (33 per arm). The recruitment and retention rates were 61.4% and 84.8%, respectively, whereas the intervention delivery fidelity was 87.5%. Exploratory analysis showed a 14.3% improvement in adherence in the intervention group (63.3%, 95%CI 61.1–65.5) compared with the control group (49%, 95%CI 46.5–51.5), though the study was not powered to test effectiveness.

conclusionsThis pilot trial showed that a packaging-based visual storytelling sticker can be successfully integrated into antibiotic dispensing workflows. Preliminary adherence differences offer estimates to inform sample size and design of a larger, definitive RCT.

trial registrationChinese Clinical Trial Registry (ChiCTR), ChiCTR2500111346. Registered on 30 October 2025. Retrospectively registered.

Indexed as

Anti-Bacterial AgentsDrug PackagingMedication AdherenceUrinary Tract InfectionsAdherence InterventionsAdultFemaleHumansMaleMiddle AgedPakistanPilot ProjectsAnti-Bacterial AgentsAntibiotic adherenceNudge interventionPilot study

Identifiers

PMID41327097
PMCPMC12771828

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.