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Clinicians' views and experiences of interventions to enhance the quality of antibiotic prescribing for acute respiratory tract infections

Clinicians' views and experiences of interventions to enhance the quality of antibiotic prescribing for acute respiratory tract infections
Clinicians' views and experiences of interventions to enhance the quality of antibiotic prescribing for acute respiratory tract infections
BACKGROUND

Evidence shows a high rate of unnecessary antibiotic prescriptions in primary care in Europe and the United States. Given the costs of widespread use and associated antibiotic resistance, reducing inappropriate use is a public health priority.

OBJECTIVE

We aimed to explore clinicians’ experiences of training in communication skills and use of a patient booklet and/or a C-reactive protein (CRP) point-of-care test to reduce antibiotic prescribing for acute respiratory tract infections (RTIs).

DESIGN

We used a qualitative research approach, interviewing clinicians who participated in a randomised controlled trial (RCT) testing two contrasting interventions.

PARTICIPANTS

General practice clinicians in Belgium, England, The Netherlands, Poland, Spain and Wales participated in the study.

APPROACH

Sixty-six semi-structured interviews were transcribed verbatim, translated into English where necessary, and analysed using thematic and framework analysis.

KEY RESULTS

Clinicians from all countries attributed benefits for themselves and their patients to using both interventions. Clinicians reported that the communication skills training and use of the patient booklet gave them greater confidence in addressing patient expectations for an antibiotic by providing answers to common questions and supporting the clinician’s own explanations. Clinicians felt the booklet could be used for a variety of patients and for different types of infections. The CRP test was viewed as a tool to decrease diagnostic uncertainty, to support non-prescription decisions, and to reassure patients, but was only necessary when clinicians were uncertain about the need for antibiotics.

CONCLUSION

Providing clinicians with training and support tools for use in practice was received positively and was valued by clinicians across countries. Interventions seemed to have influenced behaviour by increasing clinician knowledge about illness severity and prescribing, increasing confidence in making non-prescribing decisions when antibiotics were unnecessary, and enabling clinicians to anticipate positive outcomes when making such decisions. Addressing such determinants of behaviour change enabled interventions to be relevant for clinicians working across different contexts.
0884-8734
1-9
Anthierens, Sibyl
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Tonkin-Crine, Sarah
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Cals, Jochen W.
cf15c88f-856d-4793-b26a-c38aa85556ab
Coenen, Samuel
3d0dc4e0-e5ba-4d66-ba92-15900ccc551e
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Brookes-Howell, Lucy
307c5275-082d-4586-ba9d-461527607164
Fernandez-Vandellos, Patricia
816cd10b-26dd-4ab6-8618-8ba472ee07b2
Krawczyk, Jaroslaw
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Godycki-Cwirko, Maciek
306b5836-4955-470d-bf1f-77c6ac282138
Llor, Carl
a7fcfced-28f4-4771-8ca5-2c1ce2095d61
Butler, Christoper C.
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Verheij, Theo
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Goossens, Herman
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Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Francis, Nick A.
4fef3cf0-2dda-4294-bde7-e29eb33bbfdc
Anthierens, Sibyl
0022fa80-cacc-4326-bf4f-4b626445626f
Tonkin-Crine, Sarah
65679835-9bdc-48b6-92f3-cc6322cccc4f
Cals, Jochen W.
cf15c88f-856d-4793-b26a-c38aa85556ab
Coenen, Samuel
3d0dc4e0-e5ba-4d66-ba92-15900ccc551e
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Brookes-Howell, Lucy
307c5275-082d-4586-ba9d-461527607164
Fernandez-Vandellos, Patricia
816cd10b-26dd-4ab6-8618-8ba472ee07b2
Krawczyk, Jaroslaw
9cd71906-85f1-4041-a2b2-0c3a513fb8e1
Godycki-Cwirko, Maciek
306b5836-4955-470d-bf1f-77c6ac282138
Llor, Carl
a7fcfced-28f4-4771-8ca5-2c1ce2095d61
Butler, Christoper C.
d02c447d-38c0-41dc-bf1c-52c44a321120
Verheij, Theo
772e019f-486f-4a64-9260-bac6446a85d2
Goossens, Herman
31f8e1ae-7da0-473c-bd49-f911c2187451
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Francis, Nick A.
4fef3cf0-2dda-4294-bde7-e29eb33bbfdc

Anthierens, Sibyl, Tonkin-Crine, Sarah, Cals, Jochen W., Coenen, Samuel, Yardley, Lucy, Brookes-Howell, Lucy, Fernandez-Vandellos, Patricia, Krawczyk, Jaroslaw, Godycki-Cwirko, Maciek, Llor, Carl, Butler, Christoper C., Verheij, Theo, Goossens, Herman, Little, Paul and Francis, Nick A. (2014) Clinicians' views and experiences of interventions to enhance the quality of antibiotic prescribing for acute respiratory tract infections. Journal of General Internal Medicine, 1-9. (doi:10.1007/s11606-014-3076-6). (PMID:25373834)

Record type: Article

Abstract

BACKGROUND

Evidence shows a high rate of unnecessary antibiotic prescriptions in primary care in Europe and the United States. Given the costs of widespread use and associated antibiotic resistance, reducing inappropriate use is a public health priority.

OBJECTIVE

We aimed to explore clinicians’ experiences of training in communication skills and use of a patient booklet and/or a C-reactive protein (CRP) point-of-care test to reduce antibiotic prescribing for acute respiratory tract infections (RTIs).

DESIGN

We used a qualitative research approach, interviewing clinicians who participated in a randomised controlled trial (RCT) testing two contrasting interventions.

PARTICIPANTS

General practice clinicians in Belgium, England, The Netherlands, Poland, Spain and Wales participated in the study.

APPROACH

Sixty-six semi-structured interviews were transcribed verbatim, translated into English where necessary, and analysed using thematic and framework analysis.

KEY RESULTS

Clinicians from all countries attributed benefits for themselves and their patients to using both interventions. Clinicians reported that the communication skills training and use of the patient booklet gave them greater confidence in addressing patient expectations for an antibiotic by providing answers to common questions and supporting the clinician’s own explanations. Clinicians felt the booklet could be used for a variety of patients and for different types of infections. The CRP test was viewed as a tool to decrease diagnostic uncertainty, to support non-prescription decisions, and to reassure patients, but was only necessary when clinicians were uncertain about the need for antibiotics.

CONCLUSION

Providing clinicians with training and support tools for use in practice was received positively and was valued by clinicians across countries. Interventions seemed to have influenced behaviour by increasing clinician knowledge about illness severity and prescribing, increasing confidence in making non-prescribing decisions when antibiotics were unnecessary, and enabling clinicians to anticipate positive outcomes when making such decisions. Addressing such determinants of behaviour change enabled interventions to be relevant for clinicians working across different contexts.

Full text not available from this repository.

More information

Published date: 6 November 2014
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 372678
URI: https://eprints.soton.ac.uk/id/eprint/372678
ISSN: 0884-8734
PURE UUID: af90f4dc-b9c4-4ab0-9463-2162fab1d824
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

Catalogue record

Date deposited: 11 Dec 2014 16:15
Last modified: 15 Aug 2019 00:50

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Contributors

Author: Sibyl Anthierens
Author: Sarah Tonkin-Crine
Author: Jochen W. Cals
Author: Samuel Coenen
Author: Lucy Yardley ORCID iD
Author: Lucy Brookes-Howell
Author: Patricia Fernandez-Vandellos
Author: Jaroslaw Krawczyk
Author: Maciek Godycki-Cwirko
Author: Carl Llor
Author: Christoper C. Butler
Author: Theo Verheij
Author: Herman Goossens
Author: Paul Little
Author: Nick A. Francis

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