Parent and clinician views of managing children with symptoms of a lower respiratory tract infection and their influence upon decisions to take part in a placebo-controlled randomised control trial
Parent and clinician views of managing children with symptoms of a lower respiratory tract infection and their influence upon decisions to take part in a placebo-controlled randomised control trial
Children presenting with uncomplicated lower respiratory tract infections (LRTIs) commonly receive antibiotics despite public campaigns on antibiotic resistance. Qualitative interview studies were nested in a placebo-controlled trial of amoxicillin for LRTI in children. Thirty semi-structured telephone interviews were conducted with sixteen parents and fourteen clinicians to explore views of management and decisions to participate in the trial. All interviews were audio-recorded, transcribed and analysed using thematic analysis. Parents found it difficult to interpret symptoms and signs, and commonly used the type of cough (based on sound) to judge severity, highlighting the importance of better information to support parents. Provision of a clinical examination and reassurance regarding illness severity were key motivations for consulting. Many parents now acknowledge that antibiotics should only be used when 'necessary', and clinicians reported noticing a shift in parent attitudes with less demand for antibiotics and greater satisfaction with clinical assessment, reassurance and advice. Decisions to take part in the trial were influenced by the perceived risks associated with allocation to a placebo, and concerns about unnecessary use of antibiotics. Clear communication about self-management and safety-netting were identified as important when implementing 'no antibiotic' prescribing strategies to reassure parents and to support prescribing decisions.
Antibiotic prescribing, Children, Primary care, Qualitative, Respiratory tract infections
Woods, Catherine J.
239255f5-6dfe-43c4-9650-56ee03f2b06c
Morrice, Zoe
b984e4c6-8b06-4c0d-8743-3d58193fb8fb
Francis, Nick A.
9b610883-605c-4fee-871d-defaa86ccf8e
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Verheij, Theo
772e019f-486f-4a64-9260-bac6446a85d2
Leydon, Geraldine M.
c5cdaff5-0fa1-4d38-b575-b97c2892ec40
April 2021
Woods, Catherine J.
239255f5-6dfe-43c4-9650-56ee03f2b06c
Morrice, Zoe
b984e4c6-8b06-4c0d-8743-3d58193fb8fb
Francis, Nick A.
9b610883-605c-4fee-871d-defaa86ccf8e
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Verheij, Theo
772e019f-486f-4a64-9260-bac6446a85d2
Leydon, Geraldine M.
c5cdaff5-0fa1-4d38-b575-b97c2892ec40
Woods, Catherine J., Morrice, Zoe, Francis, Nick A., Little, Paul, Verheij, Theo and Leydon, Geraldine M.
(2021)
Parent and clinician views of managing children with symptoms of a lower respiratory tract infection and their influence upon decisions to take part in a placebo-controlled randomised control trial.
Antibiotics, 10 (4), [356].
(doi:10.3390/antibiotics10040356).
Abstract
Children presenting with uncomplicated lower respiratory tract infections (LRTIs) commonly receive antibiotics despite public campaigns on antibiotic resistance. Qualitative interview studies were nested in a placebo-controlled trial of amoxicillin for LRTI in children. Thirty semi-structured telephone interviews were conducted with sixteen parents and fourteen clinicians to explore views of management and decisions to participate in the trial. All interviews were audio-recorded, transcribed and analysed using thematic analysis. Parents found it difficult to interpret symptoms and signs, and commonly used the type of cough (based on sound) to judge severity, highlighting the importance of better information to support parents. Provision of a clinical examination and reassurance regarding illness severity were key motivations for consulting. Many parents now acknowledge that antibiotics should only be used when 'necessary', and clinicians reported noticing a shift in parent attitudes with less demand for antibiotics and greater satisfaction with clinical assessment, reassurance and advice. Decisions to take part in the trial were influenced by the perceived risks associated with allocation to a placebo, and concerns about unnecessary use of antibiotics. Clear communication about self-management and safety-netting were identified as important when implementing 'no antibiotic' prescribing strategies to reassure parents and to support prescribing decisions.
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Accepted/In Press date: 26 March 2021
Published date: April 2021
Additional Information:
Funding Information:
Funding: This research was funded by the NIHR Health Technology Assessment Programme.
Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
Keywords:
Antibiotic prescribing, Children, Primary care, Qualitative, Respiratory tract infections
Identifiers
Local EPrints ID: 449166
URI: http://eprints.soton.ac.uk/id/eprint/449166
ISSN: 2079-6382
PURE UUID: fec796cf-951e-4592-8f6e-608bdffb8cff
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Date deposited: 18 May 2021 16:33
Last modified: 16 Apr 2024 01:57
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Contributors
Author:
Catherine J. Woods
Author:
Zoe Morrice
Author:
Theo Verheij
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