Promoting rational antibiotic prescribing for non-complicated infections: understanding social influence in primary care networks in Germany
Abstract Background Primary care networks in Germany are formalized regional collaborations of physicians and other healthcare providers. Common goals are optimized healthcare processes and services for patients, enhanced communication, agency for professional concerns and strengthened economic powe...
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Format: | Article |
Language: | English |
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BMC
2020-03-01
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Series: | BMC Family Practice |
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Online Access: | http://link.springer.com/article/10.1186/s12875-020-01119-8 |
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author | Regina Poss-Doering Martina Kamradt Katharina Glassen Edith Andres Petra Kaufmann-Kolle Michel Wensing |
author_facet | Regina Poss-Doering Martina Kamradt Katharina Glassen Edith Andres Petra Kaufmann-Kolle Michel Wensing |
author_sort | Regina Poss-Doering |
collection | DOAJ |
description | Abstract Background Primary care networks in Germany are formalized regional collaborations of physicians and other healthcare providers. Common goals are optimized healthcare processes and services for patients, enhanced communication, agency for professional concerns and strengthened economic power. In the ARena study (Sustainable reduction of antibiotic-induced antimicrobial resistance), 14 primary care networks in two federal German states aimed to promote appropriate antibiotics use for acute non-complicated infections by fostering awareness and understanding. Factors related to the role of primary care networks were to be identified. Methods For this study, audio-recorded telephone interviews were conducted with physicians, non-physician health professionals and stakeholder representatives. Pseudonymized verbatim transcripts were coded using thematic analysis. In-depth analysis was based on the inductive categories ‘social support’, ‘social learning’, ‘social normative pressures’ and ‘social contagion’ to reflect social influence processes. Data generated through a survey with physicians and non-physician health professionals were analyzed descriptively to foster understanding of the networks’ potential impact on antibiotic prescribing. Results Social influence processes proved to be relevant regarding knowledge transfer, manifestation of best-practice care and self-reflection. Peer communication was seen as a great asset, the main reason for membership and affirmative for own perspectives. All interviewed physicians (n = 27) considered their network to be a strong support factor for daily routines, introduction of new routines, and continuity of care. They utilized network-offered training programs focusing on best practice guideline-oriented use of antibiotics and considered their networks supportive in dealing with patient expectations. A shared attitude combined with ARena intervention components facilitated reflective management of antibiotic prescribing. Non-physician health professionals (n = 11) also valued network peer exchange. They assumed their employers joined networks to offer improved and continuous care. Stakeholders (n = 7) expected networks and their members to be drivers for care optimization. Conclusion Primary care networks play a crucial role in providing a platform for professional peer exchange, social support and reassurance. With regards to their impact on antibiotic prescribing for acute non-complicated infections, networks seem to facilitate and amplify quality improvement programs by providing a platform for refreshing awareness, knowledge and self-reflection among care providers. They are well suited to promote a rational use of antibiotics. Trial registration ISRCTN, ISRCTN58150046 . Registered 24 August 2017. |
first_indexed | 2024-04-12T08:38:02Z |
format | Article |
id | doaj.art-02b3ac1b1b234280a8c4ac74b20f7315 |
institution | Directory Open Access Journal |
issn | 1471-2296 |
language | English |
last_indexed | 2024-04-12T08:38:02Z |
publishDate | 2020-03-01 |
publisher | BMC |
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series | BMC Family Practice |
spelling | doaj.art-02b3ac1b1b234280a8c4ac74b20f73152022-12-22T03:39:58ZengBMCBMC Family Practice1471-22962020-03-0121111210.1186/s12875-020-01119-8Promoting rational antibiotic prescribing for non-complicated infections: understanding social influence in primary care networks in GermanyRegina Poss-Doering0Martina Kamradt1Katharina Glassen2Edith Andres3Petra Kaufmann-Kolle4Michel Wensing5Dept. of General Practice and Health Services Research, University Hospital HeidelbergDept. of General Practice and Health Services Research, University Hospital HeidelbergDept. of General Practice and Health Services Research, University Hospital HeidelbergaQua InstitutaQua InstitutDept. of General Practice and Health Services Research, University Hospital HeidelbergAbstract Background Primary care networks in Germany are formalized regional collaborations of physicians and other healthcare providers. Common goals are optimized healthcare processes and services for patients, enhanced communication, agency for professional concerns and strengthened economic power. In the ARena study (Sustainable reduction of antibiotic-induced antimicrobial resistance), 14 primary care networks in two federal German states aimed to promote appropriate antibiotics use for acute non-complicated infections by fostering awareness and understanding. Factors related to the role of primary care networks were to be identified. Methods For this study, audio-recorded telephone interviews were conducted with physicians, non-physician health professionals and stakeholder representatives. Pseudonymized verbatim transcripts were coded using thematic analysis. In-depth analysis was based on the inductive categories ‘social support’, ‘social learning’, ‘social normative pressures’ and ‘social contagion’ to reflect social influence processes. Data generated through a survey with physicians and non-physician health professionals were analyzed descriptively to foster understanding of the networks’ potential impact on antibiotic prescribing. Results Social influence processes proved to be relevant regarding knowledge transfer, manifestation of best-practice care and self-reflection. Peer communication was seen as a great asset, the main reason for membership and affirmative for own perspectives. All interviewed physicians (n = 27) considered their network to be a strong support factor for daily routines, introduction of new routines, and continuity of care. They utilized network-offered training programs focusing on best practice guideline-oriented use of antibiotics and considered their networks supportive in dealing with patient expectations. A shared attitude combined with ARena intervention components facilitated reflective management of antibiotic prescribing. Non-physician health professionals (n = 11) also valued network peer exchange. They assumed their employers joined networks to offer improved and continuous care. Stakeholders (n = 7) expected networks and their members to be drivers for care optimization. Conclusion Primary care networks play a crucial role in providing a platform for professional peer exchange, social support and reassurance. With regards to their impact on antibiotic prescribing for acute non-complicated infections, networks seem to facilitate and amplify quality improvement programs by providing a platform for refreshing awareness, knowledge and self-reflection among care providers. They are well suited to promote a rational use of antibiotics. Trial registration ISRCTN, ISRCTN58150046 . Registered 24 August 2017.http://link.springer.com/article/10.1186/s12875-020-01119-8Primary care networksQuality improvementAppropriate antibiotics useSocial influence processesPeer exchangeMixed-methods |
spellingShingle | Regina Poss-Doering Martina Kamradt Katharina Glassen Edith Andres Petra Kaufmann-Kolle Michel Wensing Promoting rational antibiotic prescribing for non-complicated infections: understanding social influence in primary care networks in Germany BMC Family Practice Primary care networks Quality improvement Appropriate antibiotics use Social influence processes Peer exchange Mixed-methods |
title | Promoting rational antibiotic prescribing for non-complicated infections: understanding social influence in primary care networks in Germany |
title_full | Promoting rational antibiotic prescribing for non-complicated infections: understanding social influence in primary care networks in Germany |
title_fullStr | Promoting rational antibiotic prescribing for non-complicated infections: understanding social influence in primary care networks in Germany |
title_full_unstemmed | Promoting rational antibiotic prescribing for non-complicated infections: understanding social influence in primary care networks in Germany |
title_short | Promoting rational antibiotic prescribing for non-complicated infections: understanding social influence in primary care networks in Germany |
title_sort | promoting rational antibiotic prescribing for non complicated infections understanding social influence in primary care networks in germany |
topic | Primary care networks Quality improvement Appropriate antibiotics use Social influence processes Peer exchange Mixed-methods |
url | http://link.springer.com/article/10.1186/s12875-020-01119-8 |
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