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Delayed prescribing of antibiotics for acute respiratory infections by GP registrars: a qualitative study


Dallas, A and Davey, A and Mulquiney, K and Davis, J and Glasziou, P and Van Driel, M and Magin, P, Delayed prescribing of antibiotics for acute respiratory infections by GP registrars: a qualitative study, Family Practice, 37, (3) pp. 406-411. ISSN 0263-2136 (2020) [Refereed Article]

Copyright Statement

Copyright 2019 The Author(s)

DOI: doi:10.1093/fampra/cmz079


Background: Antibiotic prescribing for acute self-limiting respiratory tract infections (ARTIs) in Australia is higher than international benchmarks. Antibiotics have little or no efficacy in these conditions, and unnecessary use contributes to antibiotic resistance. Delayed prescribing has been shown to reduce antibiotic use. GP registrars are at a career-stage when long-term prescribing patterns are being established.

Aim: To explore experiences, perceptions and attitudes of GP registrars and supervisors to delayed antibiotic prescribing for ARTIs.

Design and setting: A qualitative study of Australian GP registrars and supervisors using a thematic analysis approach.

Method: GP registrars and supervisors were recruited across three Australian states/territories, using maximum variation sampling. Telephone interviews explored participants' experience and perceptions of delayed prescribing of antibiotics in ARTIs. Data collection and analysis were concurrent and iterative.

Results: A total of 12 registrars and 10 supervisors were interviewed. Key themes included the use of delayed prescribing as a safety-net in cases of diagnostic uncertainty or when clinical review was logistically difficult. Delayed prescribing was viewed as a method of educating and empowering patients, and building trust and the doctor-patient relationship. Conversely, it was also seen as a loss of control over management decisions. Supervisors, more so than registrars, appreciated the psychosocial complexity of ARTI consultations and the importance of delayed antibiotic prescribing in this context.

Conclusion: Better awareness and understanding by GP registrars of the evidence for delayed antibiotic prescription may be a means of reducing antibiotic prescribing. Understanding both registrar and supervisor usage, uncertainties and attitudes should inform educational approaches on this topic.

Item Details

Item Type:Refereed Article
Keywords:antimicrobial stewardship, general practice, graduate medical education, physician prescribing patterns, qualitative research, upper respiratory tract infections
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:General practice
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Dallas, A (Associate Professor Anthea Dallas)
ID Code:151672
Year Published:2020
Web of Science® Times Cited:6
Deposited By:Medicine
Deposited On:2022-08-03
Last Modified:2022-09-08

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