Delayed prescribing of antibiotics for acute respiratory infections by GP registrars

a qualitative study

Anthea Dallas, Andrew Davey, Katie Mulquiney, Joshua Davis, Paul Glasziou, Mieke Van Driel, Parker Magin

Research output: Contribution to journalArticleResearchpeer-review

Abstract

BACKGROUND: Antibiotic prescribing for acute self-limiting respiratory tract infections (ARTIs) in Australia is higher than international benchmarks. Antibiotics have little or no efficacy in these conditions, and unnecessary use contributes to antibiotic resistance. Delayed prescribing has been shown to reduce antibiotic use. GP registrars are at a career-stage when long-term prescribing patterns are being established.

AIM: To explore experiences, perceptions and attitudes of GP registrars and supervisors to delayed antibiotic prescribing for ARTIs.

DESIGN AND SETTING: A qualitative study of Australian GP registrars and supervisors using a thematic analysis approach.

METHOD: GP registrars and supervisors were recruited across three Australian states/territories, using maximum variation sampling. Telephone interviews explored participants' experience and perceptions of delayed prescribing of antibiotics in ARTIs. Data collection and analysis were concurrent and iterative.

RESULTS: A total of 12 registrars and 10 supervisors were interviewed. Key themes included the use of delayed prescribing as a safety-net in cases of diagnostic uncertainty or when clinical review was logistically difficult. Delayed prescribing was viewed as a method of educating and empowering patients, and building trust and the doctor-patient relationship. Conversely, it was also seen as a loss of control over management decisions. Supervisors, more so than registrars, appreciated the psychosocial complexity of ARTI consultations and the importance of delayed antibiotic prescribing in this context.

CONCLUSION: Better awareness and understanding by GP registrars of the evidence for delayed antibiotic prescription may be a means of reducing antibiotic prescribing. Understanding both registrar and supervisor usage, uncertainties and attitudes should inform educational approaches on this topic.

Original languageEnglish
JournalFamily Practice
DOIs
Publication statusE-pub ahead of print - 30 Nov 2019

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Respiratory Tract Infections
Anti-Bacterial Agents
Uncertainty
Benchmarking
Microbial Drug Resistance
Prescriptions
Referral and Consultation
Interviews
Safety

Cite this

Dallas, Anthea ; Davey, Andrew ; Mulquiney, Katie ; Davis, Joshua ; Glasziou, Paul ; Van Driel, Mieke ; Magin, Parker. / Delayed prescribing of antibiotics for acute respiratory infections by GP registrars : a qualitative study. In: Family Practice. 2019.
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abstract = "BACKGROUND: Antibiotic prescribing for acute self-limiting respiratory tract infections (ARTIs) in Australia is higher than international benchmarks. Antibiotics have little or no efficacy in these conditions, and unnecessary use contributes to antibiotic resistance. Delayed prescribing has been shown to reduce antibiotic use. GP registrars are at a career-stage when long-term prescribing patterns are being established.AIM: To explore experiences, perceptions and attitudes of GP registrars and supervisors to delayed antibiotic prescribing for ARTIs.DESIGN AND SETTING: A qualitative study of Australian GP registrars and supervisors using a thematic analysis approach.METHOD: GP registrars and supervisors were recruited across three Australian states/territories, using maximum variation sampling. Telephone interviews explored participants' experience and perceptions of delayed prescribing of antibiotics in ARTIs. Data collection and analysis were concurrent and iterative.RESULTS: A total of 12 registrars and 10 supervisors were interviewed. Key themes included the use of delayed prescribing as a safety-net in cases of diagnostic uncertainty or when clinical review was logistically difficult. Delayed prescribing was viewed as a method of educating and empowering patients, and building trust and the doctor-patient relationship. Conversely, it was also seen as a loss of control over management decisions. Supervisors, more so than registrars, appreciated the psychosocial complexity of ARTI consultations and the importance of delayed antibiotic prescribing in this context.CONCLUSION: Better awareness and understanding by GP registrars of the evidence for delayed antibiotic prescription may be a means of reducing antibiotic prescribing. Understanding both registrar and supervisor usage, uncertainties and attitudes should inform educational approaches on this topic.",
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Delayed prescribing of antibiotics for acute respiratory infections by GP registrars : a qualitative study. / Dallas, Anthea; Davey, Andrew; Mulquiney, Katie; Davis, Joshua; Glasziou, Paul; Van Driel, Mieke; Magin, Parker.

In: Family Practice, 30.11.2019.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Delayed prescribing of antibiotics for acute respiratory infections by GP registrars

T2 - a qualitative study

AU - Dallas, Anthea

AU - Davey, Andrew

AU - Mulquiney, Katie

AU - Davis, Joshua

AU - Glasziou, Paul

AU - Van Driel, Mieke

AU - Magin, Parker

N1 - © The Author(s) 2019. Published by Oxford University Press. All rights reserved.For permissions, please e-mail: journals.permissions@oup.com.

PY - 2019/11/30

Y1 - 2019/11/30

N2 - BACKGROUND: Antibiotic prescribing for acute self-limiting respiratory tract infections (ARTIs) in Australia is higher than international benchmarks. Antibiotics have little or no efficacy in these conditions, and unnecessary use contributes to antibiotic resistance. Delayed prescribing has been shown to reduce antibiotic use. GP registrars are at a career-stage when long-term prescribing patterns are being established.AIM: To explore experiences, perceptions and attitudes of GP registrars and supervisors to delayed antibiotic prescribing for ARTIs.DESIGN AND SETTING: A qualitative study of Australian GP registrars and supervisors using a thematic analysis approach.METHOD: GP registrars and supervisors were recruited across three Australian states/territories, using maximum variation sampling. Telephone interviews explored participants' experience and perceptions of delayed prescribing of antibiotics in ARTIs. Data collection and analysis were concurrent and iterative.RESULTS: A total of 12 registrars and 10 supervisors were interviewed. Key themes included the use of delayed prescribing as a safety-net in cases of diagnostic uncertainty or when clinical review was logistically difficult. Delayed prescribing was viewed as a method of educating and empowering patients, and building trust and the doctor-patient relationship. Conversely, it was also seen as a loss of control over management decisions. Supervisors, more so than registrars, appreciated the psychosocial complexity of ARTI consultations and the importance of delayed antibiotic prescribing in this context.CONCLUSION: Better awareness and understanding by GP registrars of the evidence for delayed antibiotic prescription may be a means of reducing antibiotic prescribing. Understanding both registrar and supervisor usage, uncertainties and attitudes should inform educational approaches on this topic.

AB - BACKGROUND: Antibiotic prescribing for acute self-limiting respiratory tract infections (ARTIs) in Australia is higher than international benchmarks. Antibiotics have little or no efficacy in these conditions, and unnecessary use contributes to antibiotic resistance. Delayed prescribing has been shown to reduce antibiotic use. GP registrars are at a career-stage when long-term prescribing patterns are being established.AIM: To explore experiences, perceptions and attitudes of GP registrars and supervisors to delayed antibiotic prescribing for ARTIs.DESIGN AND SETTING: A qualitative study of Australian GP registrars and supervisors using a thematic analysis approach.METHOD: GP registrars and supervisors were recruited across three Australian states/territories, using maximum variation sampling. Telephone interviews explored participants' experience and perceptions of delayed prescribing of antibiotics in ARTIs. Data collection and analysis were concurrent and iterative.RESULTS: A total of 12 registrars and 10 supervisors were interviewed. Key themes included the use of delayed prescribing as a safety-net in cases of diagnostic uncertainty or when clinical review was logistically difficult. Delayed prescribing was viewed as a method of educating and empowering patients, and building trust and the doctor-patient relationship. Conversely, it was also seen as a loss of control over management decisions. Supervisors, more so than registrars, appreciated the psychosocial complexity of ARTI consultations and the importance of delayed antibiotic prescribing in this context.CONCLUSION: Better awareness and understanding by GP registrars of the evidence for delayed antibiotic prescription may be a means of reducing antibiotic prescribing. Understanding both registrar and supervisor usage, uncertainties and attitudes should inform educational approaches on this topic.

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DO - 10.1093/fampra/cmz079

M3 - Article

JO - Family Practice

JF - Family Practice

SN - 0263-2136

ER -