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Open AccessArticle

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

1
Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
2
Antibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work, and share first authorship.
Antibiotics 2019, 8(3), 120; https://doi.org/10.3390/antibiotics8030120
Received: 12 July 2019 / Revised: 10 August 2019 / Accepted: 15 August 2019 / Published: 17 August 2019
(This article belongs to the Special Issue Feature Paper in Antibiotics for 2019)
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. View Full-Text
Keywords: quality improvement; general practitioners; primary care; antibiotics; guideline quality improvement; general practitioners; primary care; antibiotics; guideline
MDPI and ACS Style

Sunde, M.; Nygaard, M.M.; Høye, S. General Practitioners’ Attitudes toward Municipal Initiatives to Improve Antibiotic Prescribing—A Mixed-Methods Study. Antibiotics 2019, 8, 120.

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