Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/30612
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dc.contributor.authorvan der Zande, Marieke Men_UK
dc.contributor.authorDembinsky, Melanieen_UK
dc.contributor.authorAresi, Giovannien_UK
dc.contributor.authorvan Staa, Tjeerd Pen_UK
dc.date.accessioned2020-01-14T01:01:01Z-
dc.date.available2020-01-14T01:01:01Z-
dc.date.issued2019en_UK
dc.identifier.other172en_UK
dc.identifier.urihttp://hdl.handle.net/1893/30612-
dc.description.abstractBackground Antimicrobial resistance (AMR) is high on the UK public health policy agenda, and poses challenges to patient safety and the provision of health services. Widespread prescribing of antibiotics is thought to increase AMR, and mostly takes place in primary medical care. However, prescribing rates vary substantially between general practices. The aim of this study was to understand contextual factors related to general practitioners’ (GPs) antibiotic prescribing behaviour in low, high, and around the mean (medium) prescribing primary care practices. Methods Qualitative semi-structured interviews were conducted with 41 GPs working in North-West England. Participants were purposively sampled from practices with low, medium, and high antibiotic prescribing rates adjusted for the number and characteristics of patients registered in a practice. The interviews were analysed thematically. Results This study found that optimizing antibiotic prescribing creates tensions for GPs, particularly in doctor-patient communication during a consultation. GPs balanced patient expectations and their own decision-making in their communication. When not prescribing antibiotics, GPs reported the need for supportive mechanisms, such as regular practice meetings, within the practice, and in the wider healthcare system (e.g. longer consultation times). In low prescribing practices, GPs reported that increasing dialogue with colleagues, having consistent patterns of prescribing within the practice, supportive practice policies, and enough resources such as consultation time were important supports when not prescribing antibiotics. Conclusions Insight into GPs’ negotiations with patient and public health demands, and consistent and supportive practice-level policies can help support prudent antibiotic prescribing among primary care practices.en_UK
dc.language.isoenen_UK
dc.publisherBMCen_UK
dc.relationvan der Zande MM, Dembinsky M, Aresi G & van Staa TP (2019) General practitioners' accounts of negotiating antibiotic prescribing decisions with patients: a qualitative study on what influences antibiotic prescribing in low, medium and high prescribing practices. BMC Family Practice, 20, Art. No.: 172. https://doi.org/10.1186/s12875-019-1065-xen_UK
dc.rightsThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en_UK
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_UK
dc.subjectAntibiotic prescribingen_UK
dc.subjectAttitudes of health care personnelen_UK
dc.subjectPrimary health careen_UK
dc.subjectShared decision makingen_UK
dc.subjectQualitative researchen_UK
dc.titleGeneral practitioners' accounts of negotiating antibiotic prescribing decisions with patients: a qualitative study on what influences antibiotic prescribing in low, medium and high prescribing practicesen_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.1186/s12875-019-1065-xen_UK
dc.identifier.pmid31823739en_UK
dc.citation.jtitleBMC Family Practiceen_UK
dc.citation.issn1471-2296en_UK
dc.citation.issn1471-2296en_UK
dc.citation.volume20en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.contributor.funderDepartment of Healthen_UK
dc.citation.date10/12/2019en_UK
dc.contributor.affiliationUniversity of Manchesteren_UK
dc.contributor.affiliationHealth Sciences Stirlingen_UK
dc.contributor.affiliationUniversity of Manchesteren_UK
dc.contributor.affiliationUniversity of Manchesteren_UK
dc.identifier.scopusid2-s2.0-85076365793en_UK
dc.identifier.wtid1499473en_UK
dc.date.accepted2019-12-01en_UK
dc.date.filedepositdate2020-01-13en_UK
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles

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