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General Practitioners' views on the acceptability and applicability of a web-based intervention to reduce antibiotic prescribing for acute cough in multiple European countries: a qualitative study prior to a randomised trial

General Practitioners' views on the acceptability and applicability of a web-based intervention to reduce antibiotic prescribing for acute cough in multiple European countries: a qualitative study prior to a randomised trial
General Practitioners' views on the acceptability and applicability of a web-based intervention to reduce antibiotic prescribing for acute cough in multiple European countries: a qualitative study prior to a randomised trial
BACKGROUND: Interventions to promote prudent antibiotic prescribing by general practitioners (GPs) have often only been developed for use in one country. We aimed to develop an intervention which would be appropriate to implement in multiple European countries in order to offer greater benefit to practice whilst using fewer resources. The INTRO (INternet TRaining for antibiOtic use) intervention needed to deliver training to GPs in the use of C-Reactive Protein (CRP) near patient tests to help diagnose acute cough and in communication skills to help explain prescribing decisions to patients. We explored GPs' views on the initial version of INTRO to test acceptability and potentially increase applicability for use in multiple countries before the start of a randomised trial.

METHOD: 30 GPs from five countries (Belgium, England, the Netherlands, Poland and Spain), were interviewed using a "think aloud" approach. GPs were asked to work through the intervention and discuss their views on the content and format in relation to following the intervention in their own practice. GPs viewed the same intervention but versions were created in five languages. Data were coded using thematic analysis.

RESULTS: GPs in all five countries reported the view that the intervention addressed an important topic, was broadly acceptable and feasible to use, and would be a useful tool to help improve clinical practice. However, GPs in the different countries identified aspects of the intervention that did not reflect their national culture or healthcare system. These included perceived differences in communication style used in the consultation, consultation length and the stage of illness at which patient typically presented.

CONCLUSION: An online intervention to support evidence-based use of antibiotics is acceptable and feasible to implement amongst GPs in multiple countries. However, tailoring of the intervention to suit national contexts was necessary by adding local information and placing more emphasis on the fact that GPs could select the communication skills they wished to use in practice. Using think aloud methods to complement the development of interventions is a powerful method to identify regional contextual barriers to intervention implementation.
1471-2296
Anthierens, Sibyl
0022fa80-cacc-4326-bf4f-4b626445626f
Tonkin-Crine, Sarah
65679835-9bdc-48b6-92f3-cc6322cccc4f
Douglas, Elaine
96f9ae11-961d-413c-abb4-c3b78b8d4ec0
Fernandez-Vandellos, Patricia
816cd10b-26dd-4ab6-8618-8ba472ee07b2
Krawczyk, Jaroslaw
9cd71906-85f1-4041-a2b2-0c3a513fb8e1
Llor, Carl
a7fcfced-28f4-4771-8ca5-2c1ce2095d61
Cals, Jochen W.
cf15c88f-856d-4793-b26a-c38aa85556ab
Francis, Nick A.
4fef3cf0-2dda-4294-bde7-e29eb33bbfdc
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Coenen, Samuel
3d0dc4e0-e5ba-4d66-ba92-15900ccc551e
Verheij, Theo
772e019f-486f-4a64-9260-bac6446a85d2
Goossens, Herman
31f8e1ae-7da0-473c-bd49-f911c2187451
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
GRACE INTRO study team
Anthierens, Sibyl
0022fa80-cacc-4326-bf4f-4b626445626f
Tonkin-Crine, Sarah
65679835-9bdc-48b6-92f3-cc6322cccc4f
Douglas, Elaine
96f9ae11-961d-413c-abb4-c3b78b8d4ec0
Fernandez-Vandellos, Patricia
816cd10b-26dd-4ab6-8618-8ba472ee07b2
Krawczyk, Jaroslaw
9cd71906-85f1-4041-a2b2-0c3a513fb8e1
Llor, Carl
a7fcfced-28f4-4771-8ca5-2c1ce2095d61
Cals, Jochen W.
cf15c88f-856d-4793-b26a-c38aa85556ab
Francis, Nick A.
4fef3cf0-2dda-4294-bde7-e29eb33bbfdc
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Coenen, Samuel
3d0dc4e0-e5ba-4d66-ba92-15900ccc551e
Verheij, Theo
772e019f-486f-4a64-9260-bac6446a85d2
Goossens, Herman
31f8e1ae-7da0-473c-bd49-f911c2187451
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777

Anthierens, Sibyl, Tonkin-Crine, Sarah, Douglas, Elaine, Fernandez-Vandellos, Patricia, Krawczyk, Jaroslaw, Llor, Carl, Cals, Jochen W., Francis, Nick A., Yardley, Lucy, Coenen, Samuel, Verheij, Theo, Goossens, Herman and Little, Paul , GRACE INTRO study team (2012) General Practitioners' views on the acceptability and applicability of a web-based intervention to reduce antibiotic prescribing for acute cough in multiple European countries: a qualitative study prior to a randomised trial. BMC Family Practice, 13 (101). (PMID:23110756)

Record type: Article

Abstract

BACKGROUND: Interventions to promote prudent antibiotic prescribing by general practitioners (GPs) have often only been developed for use in one country. We aimed to develop an intervention which would be appropriate to implement in multiple European countries in order to offer greater benefit to practice whilst using fewer resources. The INTRO (INternet TRaining for antibiOtic use) intervention needed to deliver training to GPs in the use of C-Reactive Protein (CRP) near patient tests to help diagnose acute cough and in communication skills to help explain prescribing decisions to patients. We explored GPs' views on the initial version of INTRO to test acceptability and potentially increase applicability for use in multiple countries before the start of a randomised trial.

METHOD: 30 GPs from five countries (Belgium, England, the Netherlands, Poland and Spain), were interviewed using a "think aloud" approach. GPs were asked to work through the intervention and discuss their views on the content and format in relation to following the intervention in their own practice. GPs viewed the same intervention but versions were created in five languages. Data were coded using thematic analysis.

RESULTS: GPs in all five countries reported the view that the intervention addressed an important topic, was broadly acceptable and feasible to use, and would be a useful tool to help improve clinical practice. However, GPs in the different countries identified aspects of the intervention that did not reflect their national culture or healthcare system. These included perceived differences in communication style used in the consultation, consultation length and the stage of illness at which patient typically presented.

CONCLUSION: An online intervention to support evidence-based use of antibiotics is acceptable and feasible to implement amongst GPs in multiple countries. However, tailoring of the intervention to suit national contexts was necessary by adding local information and placing more emphasis on the fact that GPs could select the communication skills they wished to use in practice. Using think aloud methods to complement the development of interventions is a powerful method to identify regional contextual barriers to intervention implementation.

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e-pub ahead of print date: 11 October 2012
Organisations: Primary Care & Population Sciences, Psychology

Identifiers

Local EPrints ID: 345313
URI: https://eprints.soton.ac.uk/id/eprint/345313
ISSN: 1471-2296
PURE UUID: 6911ddd9-9ef5-4785-add6-67b8327d9eaa

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Date deposited: 19 Nov 2012 09:49
Last modified: 13 Oct 2017 00:29

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