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Antibiotic prescribing for acute respiratory tract infections in primary care: a systematic review and meta-ethnography

Antibiotic prescribing for acute respiratory tract infections in primary care: a systematic review and meta-ethnography
Antibiotic prescribing for acute respiratory tract infections in primary care: a systematic review and meta-ethnography
Objectives Numerous interventions have been developed to promote prudent antibiotic use for acute respiratory tract infections (ARTIs). While reviews have assessed which interventions may be most effective, none has examined why some interventions may be more effective than others. Knowing what general practitioners (GPs) feel is acceptable and feasible to implement may help to answer this question.
Methods A systematic review was undertaken of 12 studies of GPs' views and experiences of antibiotic prescribing and/or interventions promoting the prudent use of antibiotics. A meta-ethnographic approach was followed to synthesize the findings.
Results Thirteen themes were identified from the synthesis. The first discussed GPs' satisfaction with their prescribing decisions. Seven themes highlighted factors that influence GPs' prescribing decisions; these included perceptions of external pressure to reduce prescribing, uncertainty about ARTI management and previous experience of ARTI management. Five themes highlighted the benefits of interventions that had helped GPs to prescribe more prudently in practice. The last two sets of themes were linked to indicate that interventions may only be beneficial for GPs when they address one or more of the factors that influence their prescribing decisions.
Conclusions The findings suggest that interventions should incorporate five aspects to promote prudent use whilst remaining attractive to GPs and feasible in practice. In order to maximize acceptability, interventions should: allow GPs to reflect on their own prescribing; help decrease uncertainty about appropriate ARTI management; educate GPs about appropriate prescribing; facilitate more patient-centred care; and be beneficial to implement in practice.
rtis, general practitioners, attitudes of health personnel
0305-7453
2215-2223
Tonkin-Crine, Sarah
65679835-9bdc-48b6-92f3-cc6322cccc4f
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Tonkin-Crine, Sarah
65679835-9bdc-48b6-92f3-cc6322cccc4f
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777

Tonkin-Crine, Sarah, Yardley, Lucy and Little, Paul (2011) Antibiotic prescribing for acute respiratory tract infections in primary care: a systematic review and meta-ethnography. Journal of Antimicrobial Chemotherapy, 66, 2215-2223. (doi:10.1093/jac/dkr279).

Record type: Article

Abstract

Objectives Numerous interventions have been developed to promote prudent antibiotic use for acute respiratory tract infections (ARTIs). While reviews have assessed which interventions may be most effective, none has examined why some interventions may be more effective than others. Knowing what general practitioners (GPs) feel is acceptable and feasible to implement may help to answer this question.
Methods A systematic review was undertaken of 12 studies of GPs' views and experiences of antibiotic prescribing and/or interventions promoting the prudent use of antibiotics. A meta-ethnographic approach was followed to synthesize the findings.
Results Thirteen themes were identified from the synthesis. The first discussed GPs' satisfaction with their prescribing decisions. Seven themes highlighted factors that influence GPs' prescribing decisions; these included perceptions of external pressure to reduce prescribing, uncertainty about ARTI management and previous experience of ARTI management. Five themes highlighted the benefits of interventions that had helped GPs to prescribe more prudently in practice. The last two sets of themes were linked to indicate that interventions may only be beneficial for GPs when they address one or more of the factors that influence their prescribing decisions.
Conclusions The findings suggest that interventions should incorporate five aspects to promote prudent use whilst remaining attractive to GPs and feasible in practice. In order to maximize acceptability, interventions should: allow GPs to reflect on their own prescribing; help decrease uncertainty about appropriate ARTI management; educate GPs about appropriate prescribing; facilitate more patient-centred care; and be beneficial to implement in practice.

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More information

Published date: 15 July 2011
Keywords: rtis, general practitioners, attitudes of health personnel
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 195763
URI: http://eprints.soton.ac.uk/id/eprint/195763
ISSN: 0305-7453
PURE UUID: a4becd0a-fa15-4735-af32-35b84233bdd1
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 26 Aug 2011 12:20
Last modified: 15 Mar 2024 03:00

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Contributors

Author: Sarah Tonkin-Crine
Author: Lucy Yardley ORCID iD
Author: Paul Little

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