Understanding GPs’ views and experiences of using clinical prediction rules in the management of respiratory infections: a qualitative study
Understanding GPs’ views and experiences of using clinical prediction rules in the management of respiratory infections: a qualitative study
Background: respiratory tract infections (RTIs) account for 60% of antibiotic prescribing in primary care. Several clinical prediction rules (CPRs) have been developed to help reduce unnecessary prescribing for RTIs, but there is a lack of studies exploring whether or how these CPRs are being used in UK general practice. Aim: To explore UK GPs’ views and experiences with regards to RTI CPRs, and to identify barriers and facilitators to their use in practice. Design & setting: A qualitative analysis of interviews with in-hours GPs working in the South and South West of England.
Method: semi-structured qualitative telephone interviews were conducted, digitally recorded, transcribed verbatim, and analysed using an inductive thematic approach. Patient and public involvement representatives contributed to study design and interpretation of findings.
Results: thirty-two GPs were interviewed. Some CPRs were more commonly used than others. Participants used CPRs to facilitate patient—clinician discussion, confirm and support their decision, and document the consultation. GPs also highlighted concerns including lack of time, inability of CPRs to incorporate patient complexity, a shift in focus from the patient during consultations, and limited use in remote consultation (during the COVID-19 pandemic).
Conclusion: this study highlights the need for user-friendly CPRs that are readily integrated into computer systems, and easily embedded into routine practice to complement clinical decision-making. Existing CPRs need to be validated for other populations where demographics and clinical characteristics may differ, as well different settings including remote consultations and self-assessment.
diagnosis, general practice, qualitative research, respiratory illness
Hounkpatin, Hilda O.
5612e5b4-6286-48c8-b81f-e96d1148681d
Woods, Catherine
eec3c9cd-7c01-4a39-ab4b-2e01f2f348ff
Lown, Mark
4742d5f8-bcf3-4e0b-811c-920e7d010c9b
Stuart, Beth
a51c80d3-5855-4672-b24f-8c65fd2e1444
Leydon, Geraldine M.
c5cdaff5-0fa1-4d38-b575-b97c2892ec40
24 August 2021
Hounkpatin, Hilda O.
5612e5b4-6286-48c8-b81f-e96d1148681d
Woods, Catherine
eec3c9cd-7c01-4a39-ab4b-2e01f2f348ff
Lown, Mark
4742d5f8-bcf3-4e0b-811c-920e7d010c9b
Stuart, Beth
a51c80d3-5855-4672-b24f-8c65fd2e1444
Leydon, Geraldine M.
c5cdaff5-0fa1-4d38-b575-b97c2892ec40
Hounkpatin, Hilda O., Woods, Catherine, Lown, Mark, Stuart, Beth and Leydon, Geraldine M.
(2021)
Understanding GPs’ views and experiences of using clinical prediction rules in the management of respiratory infections: a qualitative study.
BJGP Open, 5 (4).
(doi:10.3399/BJGPO.2021.0096).
Abstract
Background: respiratory tract infections (RTIs) account for 60% of antibiotic prescribing in primary care. Several clinical prediction rules (CPRs) have been developed to help reduce unnecessary prescribing for RTIs, but there is a lack of studies exploring whether or how these CPRs are being used in UK general practice. Aim: To explore UK GPs’ views and experiences with regards to RTI CPRs, and to identify barriers and facilitators to their use in practice. Design & setting: A qualitative analysis of interviews with in-hours GPs working in the South and South West of England.
Method: semi-structured qualitative telephone interviews were conducted, digitally recorded, transcribed verbatim, and analysed using an inductive thematic approach. Patient and public involvement representatives contributed to study design and interpretation of findings.
Results: thirty-two GPs were interviewed. Some CPRs were more commonly used than others. Participants used CPRs to facilitate patient—clinician discussion, confirm and support their decision, and document the consultation. GPs also highlighted concerns including lack of time, inability of CPRs to incorporate patient complexity, a shift in focus from the patient during consultations, and limited use in remote consultation (during the COVID-19 pandemic).
Conclusion: this study highlights the need for user-friendly CPRs that are readily integrated into computer systems, and easily embedded into routine practice to complement clinical decision-making. Existing CPRs need to be validated for other populations where demographics and clinical characteristics may differ, as well different settings including remote consultations and self-assessment.
Text
BJGPO.2021.0096.full
- Version of Record
More information
Accepted/In Press date: 9 June 2021
e-pub ahead of print date: 14 July 2021
Published date: 24 August 2021
Additional Information:
Funding Information:
This research was funded by the National Institute of Health Research School of Primary Care Research (NIHR SPCR2014-10043).
Keywords:
diagnosis, general practice, qualitative research, respiratory illness
Identifiers
Local EPrints ID: 453879
URI: http://eprints.soton.ac.uk/id/eprint/453879
PURE UUID: cfd875b0-d8d5-4dfa-8d64-b9940c21b7ab
Catalogue record
Date deposited: 25 Jan 2022 17:42
Last modified: 18 Mar 2024 03:33
Export record
Altmetrics
Contributors
Author:
Beth Stuart
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics
