Secondary care doctors' perception of appropriate prescribing

Ljungberg, Christina; Lindblad, Åsa Kettis; Tully, Mary P.

doi:10.1111/j.1365-2753.2008.00963.x

Cited by 2 publications

(1 citation statement)

References 19 publications

(25 reference statements)

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“…Factors to the left of the point of infection are retained. Oblique rotation (direct oblimin) was chosen as factors influencing hospital prescribing are unlikely to act in isolation and behaviour is rarely partitioned into neatly packaged units that function independently . Rotation assists with identification of a simple structure by maximizing loadings of items onto one factor and minimizing them onto other factors.…”

Section: Methodsmentioning

confidence: 99%

The determinants of antimicrobial prescribing among hospital doctors in England: a framework to inform tailored stewardship interventions

Parker

Mattick

2016

Brit J Clinical Pharma

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AIMLittle is known about the determinants of antimicrobial prescribing behaviour (APB), how they vary between hospital prescribers or the mechanism by which interventions are effective. Yet, interventions based on a sound theoretical understanding of APB are more likely to be successful in changing outcomes. This study sought to quantify the potential determinants of APB among hospital doctors in south-west England. METHODSThis multicentre, quantitative study employed a closed answer questionnaire to garner hospital doctors' views on factors influencing their APB. Underlying constructs within the data were identified using exploratory factor analysis and subsequent pairwise comparisons assessed for variance between groups of prescribers. RESULTSThe questionnaire was completed by 301 doctors across four centres (response rate ≥ 74%) and three key factors were identified: autonomy, guidelines adherence and antibiotic awareness. The internal consistency for the questionnaire scale and for each factor subscale was good (α ≥ 0.7). Subgroup analysis identified significant differences between groups of prescribers: autonomy scores increased with grade until at the specialist trainee level (P ≤ 0.009), foundation doctors scored higher for guidelines adherence than consultants (P = 0.004) and specialist trainees (P = 0.003) and United Kingdom trained doctors scored higher than those trained abroad for antibiotic awareness (P < 0.0005). Scores did not vary significantly between doctors from different centres. CONCLUSIONAutonomy, guidelines adherence and antibiotic awareness were identified as important factors relevant to APB, which vary with experience and training. A theoretical framework is offered to facilitate development of more effective, tailored interventions to change APBs. British Journal of Clinical Pharmacology WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Interventions based on a sound theoretical understanding of antimicrobial prescribing behaviour (APB) are more likely to be successful in changing outcomes.• Qualitative research highlights the importance of social norms, attitudes and beliefs in antimicrobial prescribing and guidelines adherence. However, multicentre studies would confirm the generalizability of these findings. WHAT THIS STUDY ADDS• Autonomy, guidelines adherence and antibiotic awareness were identified as important factors relevant to APB, which vary with experience and training.• This study extends previous single centre qualitative interview studies to provide more generalizable insights into the perceived determinants of APB among hospital doctors in England.

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Section: Methodsmentioning

confidence: 99%