Use and feasibility of delayed prescribing for respiratory tract infections: A questionnaire survey

Høye, Sigurd; Frich, Jan C.; Lindbæk, Morten

doi:10.1186/1471-2296-12-34

Cited by 30 publications

(26 citation statements)

References 26 publications

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“…Similar to findings in other qualitative studies of delayed prescribing, [ 28 – 33 ], we found that Australian GPs were concerned about the misuse of prescriptions by patients, diagnostic uncertainty and patient hoarding of medication. We also found that Australian GPs were often highly selective regarding the patients for which they used delayed prescribing.…”

Section: Discussionsupporting

confidence: 88%

Using theory to explore facilitators and barriers to delayed prescribing in Australia: a qualitative study using the Theoretical Domains Framework and the Behaviour Change Wheel

et al. 2017

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BackgroundDelayed antibiotic prescribing reduces antibiotic use for acute respiratory infections in trials in general practice, but the uptake in clinical practice is low. The aim of the study was to identify facilitators and barriers to general practitioners’ (GPs’) use of delayed prescribing and to gain pharmacists’ and the public’s views about delayed prescribing in Australia.MethodsThis study used the Theoretical Domains Framework and the Behaviour Change Wheel to explore facilitators and barriers to delayed prescribing in Australia. Forty-three semi-structured, face-to-face interviews with general practitioners, pharmacists and patients were conducted. Responses were coded into domains of the Theoretical Domains Framework, and specific criteria from the Behaviour Change Wheel were used to identify which domains were relevant to increasing the use of delayed prescribing by GPs.ResultsThe interviews revealed nine key domains that influence GPs’ use of delayed prescribing: knowledge; cognitive and interpersonal skills; memory, attention and decision-making processes; optimism; beliefs about consequences; intentions; goals; emotion; and social influences: GPs knew about delayed prescribing; however, they did not use it consistently, preferring to bring patients back for review and only using it with patients in a highly selective way. Pharmacists would support GPs and the public in delayed prescribing but would fill the prescription if people insisted. The public said they would delay taking their antibiotics if asked by their GP and given the right information on managing symptoms and when to take antibiotics.ConclusionsUsing a theory-driven approach, we identified nine key domains that influence GPs’ willingness to provide a delayed prescription to patients with an acute respiratory infection presenting to general practice. These data can be used to develop a structured intervention to change this behaviour and thus reduce antibiotic use for acute respiratory infections in general practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-017-0589-1) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 88%

Using theory to explore facilitators and barriers to delayed prescribing in Australia: a qualitative study using the Theoretical Domains Framework and the Behaviour Change Wheel

et al. 2017

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“…We found that physicians are mostly positive towards the strategy. A previous Norwegian study also found that most GPs (69%) use delayed antibiotic prescription as a reasonable strategy for patients with sinusitis and otitis, which are more common in children [ 17 ]. Consistent with our respondents, the Norwegian physicians emphasized shared decision-making and the opportunity to educate the patients.…”

Section: Discussionmentioning

confidence: 99%

Delayed antibiotic prescription for upper respiratory tract infections in children under primary care: Physicians’ views

Raft

Bjerrum

Arpi

et al. 2017

European Journal of General Practice

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Background: Overprescribing antibiotics for common or inaccurately diagnosed childhood infections is a frequent problem in primary healthcare in most countries. Delayed antibiotic prescriptions have been shown to reduce the use of antibiotics in primary healthcare.Objective: The aim was to examine primary care physicians’ views on delayed antibiotic prescriptions to preschool children with symptoms of upper respiratory tract infections (URTIs).Methods: A questionnaire was sent to 1180 physicians working in general practice in the Capital Region of Denmark, between January and March 2015. The questions focused on physicians’ attitude and use of delayed antibiotic prescriptions to children with URTIs.Results: The response rate was 49% (n = 574). Seven per cent of the physicians often used delayed prescriptions to children with symptoms of URTI, but 46% believed that delayed prescription could reduce antibiotic use. The physicians’ views on delayed antibiotic prescription were significantly associated with their number of years working in general practice. Parents’ willingness to wait-and-see, need for reassurance, and knowledge about antibiotics influenced the physicians’ views. Also, clinical symptoms and signs, parents’ willingness to shoulder the responsibility, the capability of observation without antibiotic treatment, and structural factors like out-of-hour services were relevant factors in the decision.Conclusions: Most physicians, especially those with fewer years of practice, had a positive attitude towards delayed antibiotic prescription. Several factors influence the views of the physicians—from perceptions of parents to larger structural elements and years of experience.

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“…[ 23 ] Indeed, recent studies show that most patients are satisfied with delayed prescribing. [ 24 ]…”

Section: Discussionmentioning

confidence: 99%

Effect of Physicians' Attitudes and Knowledge on the Quality of Antibiotic Prescription: A Cohort Study

et al. 2015

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Resistance increases with the use and abuse of antibiotics. Since physicians are primarily responsible for the decision to use antibiotics, ascertaining the attitudes and knowledge that underlie their prescribing habits is thus a prerequisite for improving prescription. Three-year follow-up cohort study (2008–2010) targeting primary-care physicians (n = 2100) in Galicia, a region in NW Spain. We used data obtained from a postal survey to assess knowledge and attitudes. A physician was deemed to have demonstrated Appropriate Quality Prescription of Antibiotics (dependent variable) in any case where half or more of the indicators proposed by the European Surveillance of Antimicrobial Consumption had values that were better than the reference values for Spain. The mail-questionnaire response rate was 68·0% (1428/2100). The adjusted increase in the interquartile OR of displaying good prescribing of antibiotics for each attitude was: 205% for fear ("When in doubt, it is better to ensure that a patient is cured of an infection by using a broad-spectrum antibiotic"; 95%CI: 125% to 321%); 119% for better knowledge ("Amoxicillin is useful for resolving most respiratory infections in primary care"; 95%CI: 67% to 193%); and 21% for complacency with patients' demands ("Antibiotics are often prescribed due to patients' demands"; 95%CI: 0% to 45%). Due to the fact that physicians' knowledge and attitudes are potentially modifiable, the implementation of purpose-designed educational interventions based on the attitudes identified may well serve to improve antibiotic prescription.

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Use and feasibility of delayed prescribing for respiratory tract infections: A questionnaire survey

Cited by 30 publications

References 26 publications

Using theory to explore facilitators and barriers to delayed prescribing in Australia: a qualitative study using the Theoretical Domains Framework and the Behaviour Change Wheel

Using theory to explore facilitators and barriers to delayed prescribing in Australia: a qualitative study using the Theoretical Domains Framework and the Behaviour Change Wheel

Delayed antibiotic prescription for upper respiratory tract infections in children under primary care: Physicians’ views

Effect of Physicians' Attitudes and Knowledge on the Quality of Antibiotic Prescription: A Cohort Study

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