Understanding the delayed prescribing of antibiotics for respiratory tract infection in primary care: a qualitative analysis

R Ryves, C Eyles, M Moore, L Mcdermott, P Little, G M Leydon

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43 Citations (Scopus)
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Abstract

Objective: To identify general practitioner (GP) viewsand understanding on the use of delayed prescribing in primary care.
Design: Qualitative semistructured telephone interviewstudy.
Setting: Primary care general practices in England.
Participants: 32 GPs from identified high-prescribing
and low-prescribing general practices in England.
Method: Semistructured telephone interviews were
conducted with GPs identified from practices within
clinical commissioning groups with the highest and
lowest prescribing rates in England. A thematic
analysis of the data was conducted to generate themes.
Results: All GPs had a good understanding of
respiratory tract infection (RTI) management and how
the delayed prescribing approach could be used in
primary care. However, GPs highlighted factors that
were influential as to whether delayed prescribing was
successfully carried out during the consultation. These
included the increase in evidence of antimicrobial
resistance, and GPs’ prior experiences of using delayed
prescribing during the consultation. The patient–
practitioner relationship could also influence treatment
outcomes for RTI, and a lack of an agreed prescribing
strategy within and between practices was considered
to be of significance to GPs. Participants expressed
that a lack of feedback on prescribing data at an
individual and practice level made it difficult to know if
delayed prescribing strategies were successful in
reducing unnecessary consumption. GPs agreed that
coherent and uniform training and guidelines would be
of some benefit to ensure consistent prescribing
throughout the UK.
Conclusions: Delayed prescribing is encouraged in
primary care, but is not always implemented
successfully. Greater uniformity within and between
practices in the UK is needed to operationalise delayed
prescribing, as well as providing feedback on the
uptake of antibiotics. Finally, GPs may need further
guidance on how to answer the concerns of patients
without interpreting these questions as a demand for
antibiotics, as well as educating the patient about
antimicrobial resistance and supporting a good
patient–practitioner relationship.
Original languageEnglish
Pages (from-to)e011882
JournalBMJ Open
Volume6
Issue number11
DOIs
Publication statusPublished - 18 Nov 2016

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