Статья

Delayed Antibiotic Prescription by General Practitioners in the UK: A Stated-Choice Study

Liz MorrellHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UKJames BuchananHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UKLaurence RoopeHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UKKoen B. PouwelsHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UKChristopher ButlerNIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford OX2 6GG, UKBenedict HayhoeDepartment of Primary Care and Public Health, School of Public Health, Imperial College London, London W2 1PG, UKMichael MoorePrimary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UKSarah Tonkin‐CrineNIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford OX2 6GG, UKMonsey McLeodCentre for Medication Safety and Service Quality, Pharmacy Department, Imperial College Healthcare NHS Trust, London W2 1NY, UKJulie V. RobothamModelling and Economics Unit, National Infection Service, Public Health England, London SE1 8UG, UKA. Sarah WalkerNIHR Biomedical Research Centre Oxford, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UKSarah WordsworthHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UKon behalf of the STEPUP team

2020en

ABI

Аннотация

Delayed antibiotic prescription in primary care has been shown to reduce antibiotic consumption, without increasing risk of complications, yet is not widely used in the UK. We sought to quantify the relative importance of factors affecting the decision to give a delayed prescription, using a stated-choice survey among UK general practitioners. Respondents were asked whether they would provide a delayed or immediate prescription in fifteen hypothetical consultations, described by eight attributes. They were also asked if they would prefer not to prescribe antibiotics. The most important determinants of choice between immediate and delayed prescription were symptoms, duration of illness, and the presence of multiple comorbidities. Respondents were more likely to choose a delayed prescription if the patient preferred not to have antibiotics, but consultation length had little effect. When given the option, respondents chose not to prescribe antibiotics in 51% of cases, with delayed prescription chosen in 21%. Clinical features remained important. Patient preference did not affect the decision to give no antibiotics. We suggest that broader dissemination of the clinical evidence supporting use of delayed prescription for specific presentations may help increase appropriate use. Establishing patient preferences regarding antibiotics may help to overcome concerns about patient acceptance. Increasing consultation length appears unlikely to affect the use of delayed prescription.

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Идентификаторы

DOI: 10.3390/antibiotics9090608

Цитирования и источники

Цитирований: 2Использованных источников: 0

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