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General practitioners' attitudes and decision making regarding admission for older adults with infection: A UK qualitative interview study

General practitioners' attitudes and decision making regarding admission for older adults with infection: A UK qualitative interview study
General practitioners' attitudes and decision making regarding admission for older adults with infection: A UK qualitative interview study

Background: The world has an ageing population. Infection is common in older adults; serious infection has a high mortality rate and is associated with unplanned admissions. In the UK, general practitioners (GPs) must identify which older patients require admission to hospital and provide appropriate care and support for those staying at home. Objectives: To explore attitudes of UK GPs towards referring older patients with suspected infection to hospital, how they weigh up the decision to admit against the alternatives and how alternatives to admission could be made more effective. Methods. Qualitative study using semi-structured interviews. GPs were purposively sampled from across the UK to achieve maximum variation in terms of GP role, experience and practice population. Interview transcripts were coded and analysed using a modified framework approach. Results: GPs' key influences on decision making were grouped into patient, GP and system factors. Patient factors included clinical factors, social factors and shared decision making. GP factors included gut instinct, risk management and acknowledging an associated personal emotional burden. System factors involved weighing up the pressure on secondary care beds against increasing GP workload. GPs described that finding an alternative to admission could be more time consuming, complex to arrange or were restricted by lack of capacity. Conclusion: GPs need to be empowered to make safe decisions about place of care for older adults with suspected infection. This may mean developing strategies to support decision making as well as improving the ease of access to, and capacity of, any alternatives to admission.

80 and over, Aged, eneral practitioners, ged, nfection, rimary health care, ualitative research
0263-2136
493-500
Moore, Abigail
d993e43e-fd67-45e9-88eb-9be04fd4667d
Croxson, Caroline
52274e6a-feda-4429-9207-667adc5fcaa8
McKelvie, Sara
61c92fa0-fa9f-4d59-988d-6e669d8f8f32
Lasserson, Dan
32bfac0a-20cb-4047-9443-3f9b1af8dca1
Hayward, Gail
cdcca43f-3ee3-4094-a16b-a51b1585e9ed
Moore, Abigail
d993e43e-fd67-45e9-88eb-9be04fd4667d
Croxson, Caroline
52274e6a-feda-4429-9207-667adc5fcaa8
McKelvie, Sara
61c92fa0-fa9f-4d59-988d-6e669d8f8f32
Lasserson, Dan
32bfac0a-20cb-4047-9443-3f9b1af8dca1
Hayward, Gail
cdcca43f-3ee3-4094-a16b-a51b1585e9ed

Moore, Abigail, Croxson, Caroline, McKelvie, Sara, Lasserson, Dan and Hayward, Gail (2019) General practitioners' attitudes and decision making regarding admission for older adults with infection: A UK qualitative interview study. Family Practice, 36 (4), 493-500. (doi:10.1093/fampra/cmy083).

Record type: Article

Abstract

Background: The world has an ageing population. Infection is common in older adults; serious infection has a high mortality rate and is associated with unplanned admissions. In the UK, general practitioners (GPs) must identify which older patients require admission to hospital and provide appropriate care and support for those staying at home. Objectives: To explore attitudes of UK GPs towards referring older patients with suspected infection to hospital, how they weigh up the decision to admit against the alternatives and how alternatives to admission could be made more effective. Methods. Qualitative study using semi-structured interviews. GPs were purposively sampled from across the UK to achieve maximum variation in terms of GP role, experience and practice population. Interview transcripts were coded and analysed using a modified framework approach. Results: GPs' key influences on decision making were grouped into patient, GP and system factors. Patient factors included clinical factors, social factors and shared decision making. GP factors included gut instinct, risk management and acknowledging an associated personal emotional burden. System factors involved weighing up the pressure on secondary care beds against increasing GP workload. GPs described that finding an alternative to admission could be more time consuming, complex to arrange or were restricted by lack of capacity. Conclusion: GPs need to be empowered to make safe decisions about place of care for older adults with suspected infection. This may mean developing strategies to support decision making as well as improving the ease of access to, and capacity of, any alternatives to admission.

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More information

Published date: 1 August 2019
Keywords: 80 and over, Aged, eneral practitioners, ged, nfection, rimary health care, ualitative research

Identifiers

Local EPrints ID: 447656
URI: http://eprints.soton.ac.uk/id/eprint/447656
ISSN: 0263-2136
PURE UUID: 476d4028-718a-4326-8e0f-39c5b45670de
ORCID for Sara McKelvie: ORCID iD orcid.org/0000-0003-3781-9813

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Date deposited: 17 Mar 2021 17:39
Last modified: 17 Mar 2024 04:03

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Contributors

Author: Abigail Moore
Author: Caroline Croxson
Author: Sara McKelvie ORCID iD
Author: Dan Lasserson
Author: Gail Hayward

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