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Patient engagement with antibiotic messaging in secondary care: a qualitative feasibility study of the 'review and revise' experience

Patient engagement with antibiotic messaging in secondary care: a qualitative feasibility study of the 'review and revise' experience
Patient engagement with antibiotic messaging in secondary care: a qualitative feasibility study of the 'review and revise' experience
Background: we aimed to investigate and optimise the acceptability and usefulness of a patient leaflet about antibiotic prescribing decisions made during hospitalisation, and to explore individual patient experiences and preferences regarding the process of antibiotic prescription ‘review and revise’ which is a key strategy to minimise antibiotic overuse in hospitals.

Methods: in this qualitative study, run within the feasibility study of a large, cluster-randomised stepped wedge trial of 36 hospital organisations, a series of semi-structured, think-aloud telephone interviews were conducted and data were analysed using thematic analysis. Fifteen adult patients who had experienced a recent acute medical hospital admission during which they had been prescribed antimicrobials and offered a patient leaflet about antibiotic prescribing were recruited to the study.

Results: participants reacted positively to the leaflet, reporting that it was both an accessible and important source of information which struck the appropriate balance between informing and reassuring. Participants all valued open communication with clinicians, and were keen to be involved in antibiotic prescribing decisions, with individuals reporting positive experiences regarding antibiotic prescription changes or stopping. Many participants had prior experience or knowledge of antibiotics and resistance, and generally welcomed efforts to reduce antibiotic usage. Overall, there was a feeling that healthcare professionals (HCPs) are trusted experts providing the most appropriate treatment for individual patient conditions.

Conclusions: this study offers novel insights into how patients within secondary care are likely to respond to messages advocating a reduction in the use of antibiotics through the ‘review and revise’ approach. Due to the level of trust that patients place in their care provider, encouraging HCPs within secondary care to engage patients with greater communication and information provision could provide great advantages in the drive to reduce antibiotic use. It may also be beneficial for HCPs to view patient experiences as cumulative events that have the potential to impact future behaviour around antibiotic use. Finally, pre-testing messages about antibiotic prescribing and resistance is vital to dispelling any misconceptions either around effectiveness of treatment for patients, or perceptions of how messages may be received.
2055-5784
Mowbray, Fiona
0a9e37a7-06c7-4926-95cb-af2d1eb22157
Sivyer, Katy
c9831d57-7d6b-4bb6-bb3c-770ea7f9b116
Santillo, Marta
ea247305-2516-4c12-9c07-bf33cf659038
Jones, Nicola
8f49bd0a-d104-4526-97c1-f314af6d2ff9
Peto, Tim
fc8dfe08-1ce6-471a-90c6-8b036b52dcad
Walker, Sarah
242d1e51-7255-4de6-a538-1333cace030d
Llewelyn, Martin
057857ae-6823-40f9-a3be-1d8597a18f3d
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Mowbray, Fiona
0a9e37a7-06c7-4926-95cb-af2d1eb22157
Sivyer, Katy
c9831d57-7d6b-4bb6-bb3c-770ea7f9b116
Santillo, Marta
ea247305-2516-4c12-9c07-bf33cf659038
Jones, Nicola
8f49bd0a-d104-4526-97c1-f314af6d2ff9
Peto, Tim
fc8dfe08-1ce6-471a-90c6-8b036b52dcad
Walker, Sarah
242d1e51-7255-4de6-a538-1333cace030d
Llewelyn, Martin
057857ae-6823-40f9-a3be-1d8597a18f3d
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e

Mowbray, Fiona, Sivyer, Katy, Santillo, Marta, Jones, Nicola, Peto, Tim, Walker, Sarah, Llewelyn, Martin and Yardley, Lucy (2020) Patient engagement with antibiotic messaging in secondary care: a qualitative feasibility study of the 'review and revise' experience. Pilot and Feasibility Studies, 6, [43]. (doi:10.1186/s40814-020-00590-5).

Record type: Article

Abstract

Background: we aimed to investigate and optimise the acceptability and usefulness of a patient leaflet about antibiotic prescribing decisions made during hospitalisation, and to explore individual patient experiences and preferences regarding the process of antibiotic prescription ‘review and revise’ which is a key strategy to minimise antibiotic overuse in hospitals.

Methods: in this qualitative study, run within the feasibility study of a large, cluster-randomised stepped wedge trial of 36 hospital organisations, a series of semi-structured, think-aloud telephone interviews were conducted and data were analysed using thematic analysis. Fifteen adult patients who had experienced a recent acute medical hospital admission during which they had been prescribed antimicrobials and offered a patient leaflet about antibiotic prescribing were recruited to the study.

Results: participants reacted positively to the leaflet, reporting that it was both an accessible and important source of information which struck the appropriate balance between informing and reassuring. Participants all valued open communication with clinicians, and were keen to be involved in antibiotic prescribing decisions, with individuals reporting positive experiences regarding antibiotic prescription changes or stopping. Many participants had prior experience or knowledge of antibiotics and resistance, and generally welcomed efforts to reduce antibiotic usage. Overall, there was a feeling that healthcare professionals (HCPs) are trusted experts providing the most appropriate treatment for individual patient conditions.

Conclusions: this study offers novel insights into how patients within secondary care are likely to respond to messages advocating a reduction in the use of antibiotics through the ‘review and revise’ approach. Due to the level of trust that patients place in their care provider, encouraging HCPs within secondary care to engage patients with greater communication and information provision could provide great advantages in the drive to reduce antibiotic use. It may also be beneficial for HCPs to view patient experiences as cumulative events that have the potential to impact future behaviour around antibiotic use. Finally, pre-testing messages about antibiotic prescribing and resistance is vital to dispelling any misconceptions either around effectiveness of treatment for patients, or perceptions of how messages may be received.

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Accepted/In Press date: 24 March 2020
e-pub ahead of print date: 4 April 2020

Identifiers

Local EPrints ID: 439448
URI: http://eprints.soton.ac.uk/id/eprint/439448
ISSN: 2055-5784
PURE UUID: 435a4d60-bc63-47d6-8b80-72b512fca3d7
ORCID for Fiona Mowbray: ORCID iD orcid.org/0000-0002-3297-4163
ORCID for Katy Sivyer: ORCID iD orcid.org/0000-0003-4349-0102
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 23 Apr 2020 16:33
Last modified: 22 May 2020 00:38

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Contributors

Author: Fiona Mowbray ORCID iD
Author: Katy Sivyer ORCID iD
Author: Marta Santillo
Author: Nicola Jones
Author: Tim Peto
Author: Sarah Walker
Author: Martin Llewelyn
Author: Lucy Yardley ORCID iD

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