Social and contextual influences on antibiotic prescribing and antimicrobial stewardship: A qualitative study with Clinical Commissioning Group and general practice professionals
Antibiotic prescribing in England varies considerably between Clinical Commissioning Groups (CCGs) and general practices. We aimed to assess social and contextual factors affecting antibiotic prescribing and engagement with antimicrobial stewardship (AMS) initiatives. Semi-structured telephone inter...
| Main Authors: | , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
MDPI
2020
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| _version_ | 1797068134049382400 |
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| author | Borek, A Anthierens, S Allison, R McNulty, C Anyanwu, P Costelloe, C Walker, AS Tonkin-Crine, S |
| author_facet | Borek, A Anthierens, S Allison, R McNulty, C Anyanwu, P Costelloe, C Walker, AS Tonkin-Crine, S |
| author_sort | Borek, A |
| collection | OXFORD |
| description | Antibiotic prescribing in England varies considerably between Clinical Commissioning Groups (CCGs) and general practices. We aimed to assess social and contextual factors affecting antibiotic prescribing and engagement with antimicrobial stewardship (AMS) initiatives. Semi-structured telephone interviews were conducted with 22 CCG professionals and 19 general practice professionals. Interviews were audio-recorded, transcribed, and analyzed thematically. Social/contextual influences were grouped into the following four categories: (1) Immediate context, i.e., patients’ social characteristics (e.g., deprivation and culture), clinical factors, and practice and clinician characteristics (e.g., “struggling” with staff shortage/turnover) were linked to higher prescribing. (2) Wider context, i.e., pressures on the healthcare system, limited resources, and competing priorities were seen to reduce engagement with AMS. (3) Collaborative and whole system approaches, i.e., communication, multidisciplinary networks, leadership, and teamwork facilitated prioritizing AMS, learning, and consistency. (4) Relativity of appropriate prescribing, i.e., “high” or “appropriate” prescribing was perceived as relative, depending on comparators, and disregarding different contexts, but social norms around antibiotic use among professionals and patients seemed to be changing. Further optimization of antibiotic prescribing would benefit from addressing social/contextual factors and addressing wider health inequalities, not only targeting individual clinicians. Tailoring and adapting to local contexts and constraints, ensuring adequate time and resources for AMS, and collaborative, whole system approaches to promote consistency may help promote AMS. |
| first_indexed | 2024-03-06T22:06:18Z |
| format | Journal article |
| id | oxford-uuid:5046e617-2b77-4926-996b-3c9e68f353be |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T22:06:18Z |
| publishDate | 2020 |
| publisher | MDPI |
| record_format | dspace |
| spelling | oxford-uuid:5046e617-2b77-4926-996b-3c9e68f353be2022-03-26T16:12:35ZSocial and contextual influences on antibiotic prescribing and antimicrobial stewardship: A qualitative study with Clinical Commissioning Group and general practice professionalsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5046e617-2b77-4926-996b-3c9e68f353beEnglishSymplectic ElementsMDPI2020Borek, AAnthierens, SAllison, RMcNulty, CAnyanwu, PCostelloe, CWalker, ASTonkin-Crine, SAntibiotic prescribing in England varies considerably between Clinical Commissioning Groups (CCGs) and general practices. We aimed to assess social and contextual factors affecting antibiotic prescribing and engagement with antimicrobial stewardship (AMS) initiatives. Semi-structured telephone interviews were conducted with 22 CCG professionals and 19 general practice professionals. Interviews were audio-recorded, transcribed, and analyzed thematically. Social/contextual influences were grouped into the following four categories: (1) Immediate context, i.e., patients’ social characteristics (e.g., deprivation and culture), clinical factors, and practice and clinician characteristics (e.g., “struggling” with staff shortage/turnover) were linked to higher prescribing. (2) Wider context, i.e., pressures on the healthcare system, limited resources, and competing priorities were seen to reduce engagement with AMS. (3) Collaborative and whole system approaches, i.e., communication, multidisciplinary networks, leadership, and teamwork facilitated prioritizing AMS, learning, and consistency. (4) Relativity of appropriate prescribing, i.e., “high” or “appropriate” prescribing was perceived as relative, depending on comparators, and disregarding different contexts, but social norms around antibiotic use among professionals and patients seemed to be changing. Further optimization of antibiotic prescribing would benefit from addressing social/contextual factors and addressing wider health inequalities, not only targeting individual clinicians. Tailoring and adapting to local contexts and constraints, ensuring adequate time and resources for AMS, and collaborative, whole system approaches to promote consistency may help promote AMS. |
| spellingShingle | Borek, A Anthierens, S Allison, R McNulty, C Anyanwu, P Costelloe, C Walker, AS Tonkin-Crine, S Social and contextual influences on antibiotic prescribing and antimicrobial stewardship: A qualitative study with Clinical Commissioning Group and general practice professionals |
| title | Social and contextual influences on antibiotic prescribing and antimicrobial stewardship: A qualitative study with Clinical Commissioning Group and general practice professionals |
| title_full | Social and contextual influences on antibiotic prescribing and antimicrobial stewardship: A qualitative study with Clinical Commissioning Group and general practice professionals |
| title_fullStr | Social and contextual influences on antibiotic prescribing and antimicrobial stewardship: A qualitative study with Clinical Commissioning Group and general practice professionals |
| title_full_unstemmed | Social and contextual influences on antibiotic prescribing and antimicrobial stewardship: A qualitative study with Clinical Commissioning Group and general practice professionals |
| title_short | Social and contextual influences on antibiotic prescribing and antimicrobial stewardship: A qualitative study with Clinical Commissioning Group and general practice professionals |
| title_sort | social and contextual influences on antibiotic prescribing and antimicrobial stewardship a qualitative study with clinical commissioning group and general practice professionals |
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