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Delayed antibiotic prescription by general practitioners in the UK: A stated-choice study

Delayed antibiotic prescription by general practitioners in the UK: A stated-choice study
Delayed antibiotic prescription by general practitioners in the UK: A stated-choice study

Delayed antibiotic prescription in primary care has been shown to reduce antibiotic consumption, without increasing risk of complications, yet is not widely used in the UK. We sought to quantify the relative importance of factors affecting the decision to give a delayed prescription, using a stated-choice survey among UK general practitioners. Respondents were asked whether they would provide a delayed or immediate prescription in fifteen hypothetical consultations, described by eight attributes. They were also asked if they would prefer not to prescribe antibiotics. The most important determinants of choice between immediate and delayed prescription were symptoms, duration of illness, and the presence of multiple comorbidities. Respondents were more likely to choose a delayed prescription if the patient preferred not to have antibiotics, but consultation length had little effect. When given the option, respondents chose not to prescribe antibiotics in 51% of cases, with delayed prescription chosen in 21%. Clinical features remained important. Patient preference did not affect the decision to give no antibiotics. We suggest that broader dissemination of the clinical evidence supporting use of delayed prescription for specific presentations may help increase appropriate use. Establishing patient preferences regarding antibiotics may help to overcome concerns about patient acceptance. Increasing consultation length appears unlikely to affect the use of delayed prescription.

Antibiotic resistance, Choice experiment, Delayed prescription, General practice, Primary care, Respiratory tract infection, Stewardship, UK
2079-6382
1-19
Morrell, Liz
c492d931-70f9-4003-843c-551b1ec274ef
Buchanan, James
f789ddaa-d42d-45e5-a90f-5c77986f6dc0
Roope, Laurence S.J.
ca509aef-95f4-4cd0-8c59-596c1af21681
Pouwels, Koen B.
0f98f313-4c0b-42d9-9a50-183d32005db3
Butler, Christopher C.
1bf09f7b-0ff9-4e05-bce0-f4d60920313c
Hayhoe, Benedict
15e3e895-e88f-4517-8dbf-f36501b2a052
Moore, Michael V.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Tonkin-Crine, Sarah
65679835-9bdc-48b6-92f3-cc6322cccc4f
McLeod, Monsey
89050fbd-82e2-45b9-aa7e-be5d9143041a
Robotham, Julie V.
5eac446d-30cd-43dd-a363-5e8f240093ce
Walker, A. Sarah
e07841ba-91e9-4b85-971b-b95c299afa3a
Wordsworth, Sarah
e61bcca5-2ddf-446c-99b9-079aac165a4d
STEPUP team
Morrell, Liz
c492d931-70f9-4003-843c-551b1ec274ef
Buchanan, James
f789ddaa-d42d-45e5-a90f-5c77986f6dc0
Roope, Laurence S.J.
ca509aef-95f4-4cd0-8c59-596c1af21681
Pouwels, Koen B.
0f98f313-4c0b-42d9-9a50-183d32005db3
Butler, Christopher C.
1bf09f7b-0ff9-4e05-bce0-f4d60920313c
Hayhoe, Benedict
15e3e895-e88f-4517-8dbf-f36501b2a052
Moore, Michael V.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Tonkin-Crine, Sarah
65679835-9bdc-48b6-92f3-cc6322cccc4f
McLeod, Monsey
89050fbd-82e2-45b9-aa7e-be5d9143041a
Robotham, Julie V.
5eac446d-30cd-43dd-a363-5e8f240093ce
Walker, A. Sarah
e07841ba-91e9-4b85-971b-b95c299afa3a
Wordsworth, Sarah
e61bcca5-2ddf-446c-99b9-079aac165a4d

Morrell, Liz, Buchanan, James, Roope, Laurence S.J., Pouwels, Koen B., Butler, Christopher C., Hayhoe, Benedict, Moore, Michael V., Tonkin-Crine, Sarah, McLeod, Monsey, Robotham, Julie V., Walker, A. Sarah and Wordsworth, Sarah , STEPUP team (2020) Delayed antibiotic prescription by general practitioners in the UK: A stated-choice study. Antibiotics, 9 (9), 1-19, [608]. (doi:10.3390/antibiotics9090608).

Record type: Article

Abstract

Delayed antibiotic prescription in primary care has been shown to reduce antibiotic consumption, without increasing risk of complications, yet is not widely used in the UK. We sought to quantify the relative importance of factors affecting the decision to give a delayed prescription, using a stated-choice survey among UK general practitioners. Respondents were asked whether they would provide a delayed or immediate prescription in fifteen hypothetical consultations, described by eight attributes. They were also asked if they would prefer not to prescribe antibiotics. The most important determinants of choice between immediate and delayed prescription were symptoms, duration of illness, and the presence of multiple comorbidities. Respondents were more likely to choose a delayed prescription if the patient preferred not to have antibiotics, but consultation length had little effect. When given the option, respondents chose not to prescribe antibiotics in 51% of cases, with delayed prescription chosen in 21%. Clinical features remained important. Patient preference did not affect the decision to give no antibiotics. We suggest that broader dissemination of the clinical evidence supporting use of delayed prescription for specific presentations may help increase appropriate use. Establishing patient preferences regarding antibiotics may help to overcome concerns about patient acceptance. Increasing consultation length appears unlikely to affect the use of delayed prescription.

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More information

Accepted/In Press date: 14 September 2020
e-pub ahead of print date: 16 September 2020
Keywords: Antibiotic resistance, Choice experiment, Delayed prescription, General practice, Primary care, Respiratory tract infection, Stewardship, UK

Identifiers

Local EPrints ID: 444392
URI: http://eprints.soton.ac.uk/id/eprint/444392
ISSN: 2079-6382
PURE UUID: 4bd49e6a-c9de-4ab2-8c5d-9128541b4e83
ORCID for Michael V. Moore: ORCID iD orcid.org/0000-0002-5127-4509

Catalogue record

Date deposited: 16 Oct 2020 16:30
Last modified: 09 Jan 2022 03:18

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Contributors

Author: Liz Morrell
Author: James Buchanan
Author: Laurence S.J. Roope
Author: Koen B. Pouwels
Author: Christopher C. Butler
Author: Benedict Hayhoe
Author: Sarah Tonkin-Crine
Author: Monsey McLeod
Author: Julie V. Robotham
Author: A. Sarah Walker
Author: Sarah Wordsworth
Corporate Author: STEPUP team

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