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General practitioner and nurse prescriber experiences of prescribing antibiotics for respiratory tract infections in UK primary care out-ofhours services (the UNITE study)

General practitioner and nurse prescriber experiences of prescribing antibiotics for respiratory tract infections in UK primary care out-ofhours services (the UNITE study)
General practitioner and nurse prescriber experiences of prescribing antibiotics for respiratory tract infections in UK primary care out-ofhours services (the UNITE study)

Background: Interventions are needed to reduce unnecessary antibiotic prescribing for respiratory tract infections (RTIs). Although community antibiotic prescribing appears to be decreasing in the UK, figures for out-ofhours (OOH) prescribing have substantially increased. Understanding the factors influencing prescribing in OOH and any perceived differences between general practitioner (GP) and nurse prescriber (NP) prescribing habits may enable the development of tailored interventions promoting optimal prescribing in this setting. Objectives: To explore UK GP and NP views on and experiences of prescribing antibiotics for RTIs in primary care OOH services. Methods: Thirty semi-structured interviews were conducted with GPs and NPs working in primary care OOH services. Inductive thematic analysis was used to analyse data. Results: The research shows that factors particular to OOH influence antibiotic prescribing, including a lack of patient follow-up, access to patient GP records, consultation time, working contracts and implementation of feedback, audit and supervision. NPs reported perceptions of greater accountability for their prescribing compared with GPs and reported they had longer consultations during which they were able to discuss decisions with patients. Participants agreed that more complex cases should be seen by GPs and highlighted the importance of consistency of decision making, illness explanations to patients as well as a perception that differences in clinical training influence communication with patients and antibiotic prescribing decisions. Conclusions: Environmental and social factors in OOH services and a mixed healthcare workforce provide unique influences on antibiotic prescribing for RTIs, which would need to be considered in tailoring interventions that promote prudent antibiotic prescribing in OOH services.

0305-7453
795-803
Williams, S.J.
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Halls, A.V.
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Tonkin-Crine, S.
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Moore, M.V.
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Latter, S.E.
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Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Eyles, C.
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Postle, K.
faefe534-eca1-4657-9bdd-22f861635fc5
Leydon, G.M.
c5cdaff5-0fa1-4d38-b575-b97c2892ec40
Williams, S.J.
7cec7c3e-7247-473e-8121-f26b625893e1
Halls, A.V.
75f2a817-41cf-4283-8276-2088d7d27429
Tonkin-Crine, S.
65679835-9bdc-48b6-92f3-cc6322cccc4f
Moore, M.V.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Latter, S.E.
83f100a4-95ec-4f2e-99a5-186095de2f3b
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Eyles, C.
f8518cbb-669f-4cf6-bacb-4a174e385483
Postle, K.
faefe534-eca1-4657-9bdd-22f861635fc5
Leydon, G.M.
c5cdaff5-0fa1-4d38-b575-b97c2892ec40

Williams, S.J., Halls, A.V., Tonkin-Crine, S., Moore, M.V., Latter, S.E., Little, P., Eyles, C., Postle, K. and Leydon, G.M. (2018) General practitioner and nurse prescriber experiences of prescribing antibiotics for respiratory tract infections in UK primary care out-ofhours services (the UNITE study). Journal of Antimicrobial Chemotherapy, 73 (3), 795-803. (doi:10.1093/jac/dkx429).

Record type: Article

Abstract

Background: Interventions are needed to reduce unnecessary antibiotic prescribing for respiratory tract infections (RTIs). Although community antibiotic prescribing appears to be decreasing in the UK, figures for out-ofhours (OOH) prescribing have substantially increased. Understanding the factors influencing prescribing in OOH and any perceived differences between general practitioner (GP) and nurse prescriber (NP) prescribing habits may enable the development of tailored interventions promoting optimal prescribing in this setting. Objectives: To explore UK GP and NP views on and experiences of prescribing antibiotics for RTIs in primary care OOH services. Methods: Thirty semi-structured interviews were conducted with GPs and NPs working in primary care OOH services. Inductive thematic analysis was used to analyse data. Results: The research shows that factors particular to OOH influence antibiotic prescribing, including a lack of patient follow-up, access to patient GP records, consultation time, working contracts and implementation of feedback, audit and supervision. NPs reported perceptions of greater accountability for their prescribing compared with GPs and reported they had longer consultations during which they were able to discuss decisions with patients. Participants agreed that more complex cases should be seen by GPs and highlighted the importance of consistency of decision making, illness explanations to patients as well as a perception that differences in clinical training influence communication with patients and antibiotic prescribing decisions. Conclusions: Environmental and social factors in OOH services and a mixed healthcare workforce provide unique influences on antibiotic prescribing for RTIs, which would need to be considered in tailoring interventions that promote prudent antibiotic prescribing in OOH services.

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General Practitioner and Nurse Prescriber experiences of prescribing antibiotics for respiratory tract infections in UK primary care out of hours services (The UNITE Study) - Accepted Manuscript
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General Practitioner and Nurse Prescriber experiences of prescribing antibiotics UNITEScheduleSupplement - Accepted Manuscript
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More information

Accepted/In Press date: 20 October 2017
e-pub ahead of print date: 27 November 2017
Published date: 1 March 2018

Identifiers

Local EPrints ID: 415395
URI: http://eprints.soton.ac.uk/id/eprint/415395
ISSN: 0305-7453
PURE UUID: dcdfa712-37e9-4fc8-b920-6446fd2a9677
ORCID for S.J. Williams: ORCID iD orcid.org/0000-0001-9505-6485
ORCID for M.V. Moore: ORCID iD orcid.org/0000-0002-5127-4509
ORCID for S.E. Latter: ORCID iD orcid.org/0000-0003-0973-0512
ORCID for G.M. Leydon: ORCID iD orcid.org/0000-0001-5986-3300

Catalogue record

Date deposited: 09 Nov 2017 17:30
Last modified: 17 Dec 2019 05:48

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Contributors

Author: S.J. Williams ORCID iD
Author: A.V. Halls
Author: S. Tonkin-Crine
Author: M.V. Moore ORCID iD
Author: S.E. Latter ORCID iD
Author: P. Little
Author: C. Eyles
Author: K. Postle
Author: G.M. Leydon ORCID iD

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