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A qualitative interview study of antibiotics and self-management strategies for respiratory infections in primary care

A qualitative interview study of antibiotics and self-management strategies for respiratory infections in primary care
A qualitative interview study of antibiotics and self-management strategies for respiratory infections in primary care
Objective: To explore perceptions of illness, the decisions to consult, and the acceptability of delayed antibiotic prescriptions and self-help treatments for respiratory tract infections (RTIs).

Design: Qualitative semi-structured interview study.

Setting: UK Primary care.

Participants: 20 adult patients who had been participating in the ‘PIPS’ (Pragmatic Ibuprofen Paracetamol and Steam) trial in the South of England.

Method: Semi-structured, telephone interviews were conducted with participants to explore their experiences and views on various treatments for RTI.

Results: Participants had concerns about symptoms which were not clinically serious and were mostly unaware of the natural history of RTIs, but were aware of the limitations of antibiotics and did not expect them with every consultation. Most viewed delayed prescriptions positively and had no strong preference over which technique is used to deliver the delayed antibiotic, but some patients received mixed messages, such as being told their infection was viral then being given an antibiotic, or were sceptical about the rationale. Participants disliked self-help treatments that involved taking medication and were particularly concerned about painkillers in combination. Steam inhalation was viewed as only moderately helpful for mild symptoms.

Conclusion: Delayed prescribing is acceptable no matter how the delay is operationalized, but explanation of the rationale is needed and care taken to minimise mixed messages about the severity of illnesses and causation by viruses or bacteria. Better access is needed to good natural history information, and the signs and symptoms requiring or not requiring GP advice. Significant concerns about paracetamol, ibuprofen and steal inhalation are likely to need careful exploration in the consultation.
2044-6055
McDermott, L.
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Leydon, G.M.
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Halls, A.
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Kelly, J.
b7094829-aeb1-4bc1-b64c-7b7c716f73b5
Nagle, A.
84b7de93-10c7-4bf3-b036-04ab4918c03b
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
White, J.
01e2f8af-9f58-47a3-a787-5098e449ac4a
McDermott, L.
10aa4fe3-7260-4080-8f8b-7c14b3ca409e
Leydon, G.M.
c5cdaff5-0fa1-4d38-b575-b97c2892ec40
Halls, A.
75f2a817-41cf-4283-8276-2088d7d27429
Kelly, J.
b7094829-aeb1-4bc1-b64c-7b7c716f73b5
Nagle, A.
84b7de93-10c7-4bf3-b036-04ab4918c03b
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
White, J.
01e2f8af-9f58-47a3-a787-5098e449ac4a

McDermott, L., Leydon, G.M., Halls, A., Kelly, J., Nagle, A., Little, P. and White, J. (2017) A qualitative interview study of antibiotics and self-management strategies for respiratory infections in primary care. BMJ Open. (In Press)

Record type: Article

Abstract

Objective: To explore perceptions of illness, the decisions to consult, and the acceptability of delayed antibiotic prescriptions and self-help treatments for respiratory tract infections (RTIs).

Design: Qualitative semi-structured interview study.

Setting: UK Primary care.

Participants: 20 adult patients who had been participating in the ‘PIPS’ (Pragmatic Ibuprofen Paracetamol and Steam) trial in the South of England.

Method: Semi-structured, telephone interviews were conducted with participants to explore their experiences and views on various treatments for RTI.

Results: Participants had concerns about symptoms which were not clinically serious and were mostly unaware of the natural history of RTIs, but were aware of the limitations of antibiotics and did not expect them with every consultation. Most viewed delayed prescriptions positively and had no strong preference over which technique is used to deliver the delayed antibiotic, but some patients received mixed messages, such as being told their infection was viral then being given an antibiotic, or were sceptical about the rationale. Participants disliked self-help treatments that involved taking medication and were particularly concerned about painkillers in combination. Steam inhalation was viewed as only moderately helpful for mild symptoms.

Conclusion: Delayed prescribing is acceptable no matter how the delay is operationalized, but explanation of the rationale is needed and care taken to minimise mixed messages about the severity of illnesses and causation by viruses or bacteria. Better access is needed to good natural history information, and the signs and symptoms requiring or not requiring GP advice. Significant concerns about paracetamol, ibuprofen and steal inhalation are likely to need careful exploration in the consultation.

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PIPS resubsmission 2nd UNMARKED v2 - Accepted Manuscript
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Accepted/In Press date: 17 August 2017

Identifiers

Local EPrints ID: 413448
URI: https://eprints.soton.ac.uk/id/eprint/413448
ISSN: 2044-6055
PURE UUID: d8e84b06-a183-412e-b3cf-8745468949a6
ORCID for G.M. Leydon: ORCID iD orcid.org/0000-0001-5986-3300

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Date deposited: 24 Aug 2017 16:30
Last modified: 13 Jun 2019 00:35

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Contributors

Author: L. McDermott
Author: G.M. Leydon ORCID iD
Author: A. Halls
Author: J. Kelly
Author: A. Nagle
Author: P. Little
Author: J. White

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