dc.contributor.author | Germeni, E | |
dc.contributor.author | Frost, J | |
dc.contributor.author | Garside, R | |
dc.contributor.author | Rogers, M | |
dc.contributor.author | Valderas, JM | |
dc.contributor.author | Britten, N | |
dc.date.accessioned | 2018-07-25T08:43:05Z | |
dc.date.issued | 2018-06-18 | |
dc.description.abstract | BACKGROUND: Reducing unnecessary prescribing remains a key priority for tackling the global rise of antibiotic-resistant infections. AIM: The authors sought to update a 2011 qualitative synthesis of GPs' experiences of antibiotic prescribing for acute respiratory tract infections (ARTIs), including their views of interventions aimed at more prudent prescribing. They expanded the original scope to encompass all primary care professionals (PCPs) who can prescribe or dispense antibiotics for ARTIs (for example, nurses and pharmacists). DESIGN AND SETTING: Systematic review and meta-ethnography of qualitative studies. METHOD: A systematic search was conducted on MEDLINE, EMBASE, PsycINFO, CINAHL, ASSIA, and Web of Science. No date or language restrictions were used. Identified studies were grouped according to their thematic focus (usual care versus intervention), and two separate syntheses were performed. RESULTS: In all, 53 articles reporting the experiences of >1200 PCPs were included. Analysis of usual-care studies showed that PCPs tend to assume multiple roles in the context of ARTI consultations (the expert self, the benevolent self, the practical self), depending on the range of intrapersonal, interpersonal, and contextual situations in which they find themselves. Analysis of intervention studies identified four possible ways in which PCPs may experience quality improvement interventions (compromise, 'supportive aids', source of distress, and unnecessary). CONCLUSION: Contrary to the original review, these results suggest that the use of the same intervention is experienced in a totally different way by different PCPs, and that the same elements that are perceived as benefits by some could be viewed as drawbacks by others. Acceptability of interventions is likely to increase if these are context sensitive and take into account PCPs' varying roles and changing priorities. | en_GB |
dc.description.sponsorship | Evi Germeni was supported by an Advanced Postdoc Mobility grant from the Swiss National Science Foundation (P300P1_164574). Ruth Garside, Morwenna Rogers, and Nicky Britten were partially
supported by the UK National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula. The content is
solely the responsibility of the authors and does not necessarily represent the views of the Swiss National Science Foundation, the UK NIHR, the UK NHS, or the UK Department of Health. | en_GB |
dc.identifier.citation | Published online 18-June-2018 | en_GB |
dc.identifier.doi | 10.3399/bjgp18X697889 | |
dc.identifier.uri | http://hdl.handle.net/10871/33529 | |
dc.language.iso | en | en_GB |
dc.publisher | Royal College of General Practitioners | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/29914880 | en_GB |
dc.rights.embargoreason | Under embargo until 18 June 2019 in compliance with publisher policy. | en_GB |
dc.rights | ©British Journal of General Practice
This is the full-length article (published online 19 Jun 2018) of an abridged version published in print. Cite this version as: Br J Gen Pract 2018; DOI: https://doi.org/10.3399/bjgp18X697889 | en_GB |
dc.subject | antibacterial agents | en_GB |
dc.subject | inappropriate prescribing | en_GB |
dc.subject | interventions | en_GB |
dc.subject | primary health care | en_GB |
dc.subject | qualitative research | en_GB |
dc.subject | respiratory tract infections | en_GB |
dc.title | Antibiotic prescribing for acute respiratory tract infections in primary care: an updated and expanded meta-ethnography. | en_GB |
dc.type | Article | en_GB |
dc.identifier.issn | 0960-1643 | |
exeter.place-of-publication | England | en_GB |
dc.description | This is the author accepted manuscript. The final version is available from Royal College of General Practitioners via the DOI in this record. | en_GB |
dc.identifier.journal | British Journal of General Practitioners | en_GB |