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Clinician acceptability of an antibiotic prescribing knowledge support system for primary care: a mixed-method evaluation of features and context

BACKGROUND: Overprescribing of antibiotics is a major concern as it contributes to antimicrobial resistance. Research has found highly variable antibiotic prescribing in (UK) primary care, and to support more effective stewardship, the BRIT Project (Building Rapid Interventions to optimise prescribi...

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Autores principales: Hurley, Ruth, Jury, Francine, van Staa, Tjeerd P., Palin, Victoria, Armitage, Christopher J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10103677/
https://www.ncbi.nlm.nih.gov/pubmed/37060063
http://dx.doi.org/10.1186/s12913-023-09239-4
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author Hurley, Ruth
Jury, Francine
van Staa, Tjeerd P.
Palin, Victoria
Armitage, Christopher J.
author_facet Hurley, Ruth
Jury, Francine
van Staa, Tjeerd P.
Palin, Victoria
Armitage, Christopher J.
author_sort Hurley, Ruth
collection PubMed
description BACKGROUND: Overprescribing of antibiotics is a major concern as it contributes to antimicrobial resistance. Research has found highly variable antibiotic prescribing in (UK) primary care, and to support more effective stewardship, the BRIT Project (Building Rapid Interventions to optimise prescribing) is implementing an eHealth Knowledge Support System. This will provide unique individualised analytics information to clinicians and patients at the point of care. The objective of the current study was to gauge the acceptability of the system to prescribing healthcare professionals and highlight factors to maximise intervention uptake. METHODS: Two mixed-method co-design workshops were held online with primary care prescribing healthcare professionals (n = 16). Usefulness ratings of example features were collected using online polls and online whiteboards. Verbal discussion and textual comments were analysed thematically using inductive (participant-centred) and deductive perspectives (using the Theoretical Framework of Acceptability). RESULTS: Hierarchical thematic coding generated three overarching themes relevant to intervention use and development. Clinician concerns (focal issues) were safe prescribing, accessible information, autonomy, avoiding duplication, technical issues and time. Requirements were ease and efficiency of use, integration of systems, patient-centeredness, personalisation, and training. Important features of the system included extraction of pertinent information from patient records (such as antibiotic prescribing history), recommended actions, personalised treatment, risk indicators and electronic patient communication leaflets. Anticipated acceptability and intention to use the knowledge support system was moderate to high. Time was identified as a focal cost/ burden, but this would be outweighed if the system improved patient outcomes and increased prescribing confidence. CONCLUSION: Clinicians anticipate that an eHealth knowledge support system will be a useful and acceptable way to optimise antibiotic prescribing at the point of care. The mixed method workshop highlighted issues to assist person-centred eHealth intervention development, such as the value of communicating patient outcomes. Important features were identified including the ability to efficiently extract and summarise pertinent information from the patient records, provide explainable and transparent risk information, and personalised information to support patient communication. The Theoretical Framework of Acceptability enabled structured, theoretically sound feedback and creation of a profile to benchmark future evaluations. This may encourage a consistent user-focused approach to guide future eHealth intervention development. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-09239-4.
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spelling pubmed-101036772023-04-16 Clinician acceptability of an antibiotic prescribing knowledge support system for primary care: a mixed-method evaluation of features and context Hurley, Ruth Jury, Francine van Staa, Tjeerd P. Palin, Victoria Armitage, Christopher J. BMC Health Serv Res Research BACKGROUND: Overprescribing of antibiotics is a major concern as it contributes to antimicrobial resistance. Research has found highly variable antibiotic prescribing in (UK) primary care, and to support more effective stewardship, the BRIT Project (Building Rapid Interventions to optimise prescribing) is implementing an eHealth Knowledge Support System. This will provide unique individualised analytics information to clinicians and patients at the point of care. The objective of the current study was to gauge the acceptability of the system to prescribing healthcare professionals and highlight factors to maximise intervention uptake. METHODS: Two mixed-method co-design workshops were held online with primary care prescribing healthcare professionals (n = 16). Usefulness ratings of example features were collected using online polls and online whiteboards. Verbal discussion and textual comments were analysed thematically using inductive (participant-centred) and deductive perspectives (using the Theoretical Framework of Acceptability). RESULTS: Hierarchical thematic coding generated three overarching themes relevant to intervention use and development. Clinician concerns (focal issues) were safe prescribing, accessible information, autonomy, avoiding duplication, technical issues and time. Requirements were ease and efficiency of use, integration of systems, patient-centeredness, personalisation, and training. Important features of the system included extraction of pertinent information from patient records (such as antibiotic prescribing history), recommended actions, personalised treatment, risk indicators and electronic patient communication leaflets. Anticipated acceptability and intention to use the knowledge support system was moderate to high. Time was identified as a focal cost/ burden, but this would be outweighed if the system improved patient outcomes and increased prescribing confidence. CONCLUSION: Clinicians anticipate that an eHealth knowledge support system will be a useful and acceptable way to optimise antibiotic prescribing at the point of care. The mixed method workshop highlighted issues to assist person-centred eHealth intervention development, such as the value of communicating patient outcomes. Important features were identified including the ability to efficiently extract and summarise pertinent information from the patient records, provide explainable and transparent risk information, and personalised information to support patient communication. The Theoretical Framework of Acceptability enabled structured, theoretically sound feedback and creation of a profile to benchmark future evaluations. This may encourage a consistent user-focused approach to guide future eHealth intervention development. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-09239-4. BioMed Central 2023-04-14 /pmc/articles/PMC10103677/ /pubmed/37060063 http://dx.doi.org/10.1186/s12913-023-09239-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Hurley, Ruth
Jury, Francine
van Staa, Tjeerd P.
Palin, Victoria
Armitage, Christopher J.
Clinician acceptability of an antibiotic prescribing knowledge support system for primary care: a mixed-method evaluation of features and context
title Clinician acceptability of an antibiotic prescribing knowledge support system for primary care: a mixed-method evaluation of features and context
title_full Clinician acceptability of an antibiotic prescribing knowledge support system for primary care: a mixed-method evaluation of features and context
title_fullStr Clinician acceptability of an antibiotic prescribing knowledge support system for primary care: a mixed-method evaluation of features and context
title_full_unstemmed Clinician acceptability of an antibiotic prescribing knowledge support system for primary care: a mixed-method evaluation of features and context
title_short Clinician acceptability of an antibiotic prescribing knowledge support system for primary care: a mixed-method evaluation of features and context
title_sort clinician acceptability of an antibiotic prescribing knowledge support system for primary care: a mixed-method evaluation of features and context
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10103677/
https://www.ncbi.nlm.nih.gov/pubmed/37060063
http://dx.doi.org/10.1186/s12913-023-09239-4
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