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"I'm Dr Jekyll and Mr Hyde": Are GPs' antibiotic prescribing patterns contextually dependent? A qualitative focus group study.

Strandberg, Eva-Lena LU ; Brorsson, Annika LU ; Hagstam, Charlotta LU ; Troein, Margareta LU and Hedin, Katarina LU (2013) In Scandinavian Journal of Primary Health Care 31(3). p.158-165
Abstract
Abstract Objective. To explore factors and circumstances contributing to prudent antibiotic prescribing for respiratory tract infections in primary care. Design. Two focus groups representing rural and urban areas. A semi-structured interview guide with open-ended questions and an editing analysis style was used. They were examined to identify meaning units that were sorted into categories in an iterative process throughout the analysis. Setting. Primary health care in two counties in southern Sweden. Subjects. Two groups including seven and six general practitioners (GPs) respectively, men and women of different ages with different professional experiences. Main outcome measures. Exploration of categories, determination of themes,... (More)
Abstract Objective. To explore factors and circumstances contributing to prudent antibiotic prescribing for respiratory tract infections in primary care. Design. Two focus groups representing rural and urban areas. A semi-structured interview guide with open-ended questions and an editing analysis style was used. They were examined to identify meaning units that were sorted into categories in an iterative process throughout the analysis. Setting. Primary health care in two counties in southern Sweden. Subjects. Two groups including seven and six general practitioners (GPs) respectively, men and women of different ages with different professional experiences. Main outcome measures. Exploration of categories, determination of themes, construction of models. Results. The decision to prescribe antibiotics takes place in the encounter between GP and patient, initially characterized by harmony or fight and the subsequent process by collaboration or negotiation, resulting in agreement, compromise, or disagreement. Several factors influence the meeting and contribute to enhancing the conditions for rational prescribing. These conditions are connected to the GP, the relationship, and the setting; organization as well as professional culture. The findings indicate synergies between the factors, and that one factor can sometimes compensate for lack of another. Continuity and mutual trust can make a brief consultation successful, but lack of continuity can eliminate the effects of knowledge and professional skills. Conclusions. The findings emphasize the importance of the encounter between the GP and the patient for prudent antibiotic prescribing. Furthermore, the importance of an appropriate organization of primary care, which promotes continuity and encourages professional autonomy, is demonstrated. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Primary Health Care
volume
31
issue
3
pages
158 - 165
publisher
Taylor & Francis
external identifiers
  • wos:000323243900008
  • pmid:23941086
  • scopus:84882373500
ISSN
0281-3432
DOI
10.3109/02813432.2013.824156
language
English
LU publication?
yes
id
077c718e-5aab-413b-b7cb-66817cf46b4a (old id 4005782)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23941086?dopt=Abstract
date added to LUP
2013-09-04 16:20:04
date last changed
2019-02-20 03:08:52
@article{077c718e-5aab-413b-b7cb-66817cf46b4a,
  abstract     = {Abstract Objective. To explore factors and circumstances contributing to prudent antibiotic prescribing for respiratory tract infections in primary care. Design. Two focus groups representing rural and urban areas. A semi-structured interview guide with open-ended questions and an editing analysis style was used. They were examined to identify meaning units that were sorted into categories in an iterative process throughout the analysis. Setting. Primary health care in two counties in southern Sweden. Subjects. Two groups including seven and six general practitioners (GPs) respectively, men and women of different ages with different professional experiences. Main outcome measures. Exploration of categories, determination of themes, construction of models. Results. The decision to prescribe antibiotics takes place in the encounter between GP and patient, initially characterized by harmony or fight and the subsequent process by collaboration or negotiation, resulting in agreement, compromise, or disagreement. Several factors influence the meeting and contribute to enhancing the conditions for rational prescribing. These conditions are connected to the GP, the relationship, and the setting; organization as well as professional culture. The findings indicate synergies between the factors, and that one factor can sometimes compensate for lack of another. Continuity and mutual trust can make a brief consultation successful, but lack of continuity can eliminate the effects of knowledge and professional skills. Conclusions. The findings emphasize the importance of the encounter between the GP and the patient for prudent antibiotic prescribing. Furthermore, the importance of an appropriate organization of primary care, which promotes continuity and encourages professional autonomy, is demonstrated.},
  author       = {Strandberg, Eva-Lena and Brorsson, Annika and Hagstam, Charlotta and Troein, Margareta and Hedin, Katarina},
  issn         = {0281-3432},
  language     = {eng},
  number       = {3},
  pages        = {158--165},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Primary Health Care},
  title        = {"I'm Dr Jekyll and Mr Hyde": Are GPs' antibiotic prescribing patterns contextually dependent? A qualitative focus group study.},
  url          = {http://dx.doi.org/10.3109/02813432.2013.824156},
  volume       = {31},
  year         = {2013},
}