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General Practitioners’ Attitudes toward Municipal Initiatives to Improve Antibiotic Prescribing—A Mixed-Methods Study

Antimicrobial stewardship (AMS) interventions directed at general practitioners (GPs) contribute to an improved antibiotic prescribing. However, it is challenging to implement and maintain such interventions at a national level. Involving the municipalities’ Chief Medical Officer (MCMO) in quality i...

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Autores principales: Sunde, Marthe, Nygaard, Marthe Marie, Høye, Sigurd
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6783816/
https://www.ncbi.nlm.nih.gov/pubmed/31426530
http://dx.doi.org/10.3390/antibiotics8030120
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author Sunde, Marthe
Nygaard, Marthe Marie
Høye, Sigurd
author_facet Sunde, Marthe
Nygaard, Marthe Marie
Høye, Sigurd
author_sort Sunde, Marthe
collection PubMed
description Antimicrobial stewardship (AMS) interventions directed at general practitioners (GPs) contribute to an improved antibiotic prescribing. However, it is challenging to implement and maintain such interventions at a national level. Involving the municipalities’ Chief Medical Officer (MCMO) in quality improvement activities may simplify the implementation and maintenance, but may also be perceived challenging for the GPs. In the ENORM (Educational intervention in NORwegian Municipalities for antibiotic treatment in line with guidelines) study, MCMOs acted as facilitators of an AMS intervention for GPs. We explored GPs’ views on their own antibiotic prescribing, and their views on MCMO involvement in improving antibiotic prescribing in general practice. This is a mixed-methods study combining quantitative and qualitative data from two data sources: e-mail interviews with 15 GPs prior to the ENORM intervention, and online-form answers to closed and open-ended questions from 132 GPs participating in the ENORM intervention. The interviews and open-ended responses were analyzed using systematic text condensation. Many GPs admitted to occasionally prescribing antibiotics without medical indication, mainly due to pressure from patients. Too liberal treatment guidelines were also seen as a reason for overtreatment. The MCMO was considered a suitable and acceptable facilitator of quality improvement activities in general practice, and their involvement was regarded as unproblematic (scale 0 (very problematic) to 10 (not problematic at all): mean 8.2, median 10). GPs acknowledge the need and possibility to improve their own antibiotic prescribing, and in doing so, they welcome engagement from the municipality. MCMOs should be involved in quality improvement and AMS in general practice.
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spelling pubmed-67838162019-10-16 General Practitioners’ Attitudes toward Municipal Initiatives to Improve Antibiotic Prescribing—A Mixed-Methods Study Sunde, Marthe Nygaard, Marthe Marie Høye, Sigurd Antibiotics (Basel) Article Antimicrobial stewardship (AMS) interventions directed at general practitioners (GPs) contribute to an improved antibiotic prescribing. However, it is challenging to implement and maintain such interventions at a national level. Involving the municipalities’ Chief Medical Officer (MCMO) in quality improvement activities may simplify the implementation and maintenance, but may also be perceived challenging for the GPs. In the ENORM (Educational intervention in NORwegian Municipalities for antibiotic treatment in line with guidelines) study, MCMOs acted as facilitators of an AMS intervention for GPs. We explored GPs’ views on their own antibiotic prescribing, and their views on MCMO involvement in improving antibiotic prescribing in general practice. This is a mixed-methods study combining quantitative and qualitative data from two data sources: e-mail interviews with 15 GPs prior to the ENORM intervention, and online-form answers to closed and open-ended questions from 132 GPs participating in the ENORM intervention. The interviews and open-ended responses were analyzed using systematic text condensation. Many GPs admitted to occasionally prescribing antibiotics without medical indication, mainly due to pressure from patients. Too liberal treatment guidelines were also seen as a reason for overtreatment. The MCMO was considered a suitable and acceptable facilitator of quality improvement activities in general practice, and their involvement was regarded as unproblematic (scale 0 (very problematic) to 10 (not problematic at all): mean 8.2, median 10). GPs acknowledge the need and possibility to improve their own antibiotic prescribing, and in doing so, they welcome engagement from the municipality. MCMOs should be involved in quality improvement and AMS in general practice. MDPI 2019-08-17 /pmc/articles/PMC6783816/ /pubmed/31426530 http://dx.doi.org/10.3390/antibiotics8030120 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sunde, Marthe
Nygaard, Marthe Marie
Høye, Sigurd
General Practitioners’ Attitudes toward Municipal Initiatives to Improve Antibiotic Prescribing—A Mixed-Methods Study
title General Practitioners’ Attitudes toward Municipal Initiatives to Improve Antibiotic Prescribing—A Mixed-Methods Study
title_full General Practitioners’ Attitudes toward Municipal Initiatives to Improve Antibiotic Prescribing—A Mixed-Methods Study
title_fullStr General Practitioners’ Attitudes toward Municipal Initiatives to Improve Antibiotic Prescribing—A Mixed-Methods Study
title_full_unstemmed General Practitioners’ Attitudes toward Municipal Initiatives to Improve Antibiotic Prescribing—A Mixed-Methods Study
title_short General Practitioners’ Attitudes toward Municipal Initiatives to Improve Antibiotic Prescribing—A Mixed-Methods Study
title_sort general practitioners’ attitudes toward municipal initiatives to improve antibiotic prescribing—a mixed-methods study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6783816/
https://www.ncbi.nlm.nih.gov/pubmed/31426530
http://dx.doi.org/10.3390/antibiotics8030120
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