BJGP Open最新文献_第4页

Exploring considerations for becoming a GP practice owner: a qualitative study.

IF 2.5

BJGP Open Pub Date : 2025-03-12 DOI: 10.3399/BJGPO.2024.0213

Hinda Stegeman, Manna A Alma, Hanneke Pm Vervoort, Vivian van Vliet, Nynke D Scherpbier, Danielle Jansen, Marjolein Berger

{"title":"Exploring considerations for becoming a GP practice owner: a qualitative study.","authors":"Hinda Stegeman, Manna A Alma, Hanneke Pm Vervoort, Vivian van Vliet, Nynke D Scherpbier, Danielle Jansen, Marjolein Berger","doi":"10.3399/BJGPO.2024.0213","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0213","url":null,"abstract":"Background: General practice owners are responsible for access to care 24 hours a day, but they can struggle to find associates or successors. Fewer practice owners means that the core value, continuity of care (COC), is at risk. However, little is known about the career considerations of young GPs and barriers and facilitators to become practice owners.Aim: To explore the considerations of GPs for becoming a practice owner.Design & setting: A qualitative study of GP trainees, freelance/salaried GPs, practice owners, and ex-practice owners in the north of the Netherlands.Method: Ninety GPs were purposively recruited for focus groups and interviews, which were audio/video recorded, transcribed verbatim, and analysed thematically.Results: Becoming a practice owner results from a complex interplay between professional, personal, external, and process-related factors, often over an extended period. Participants indicated that COC, autonomy, and personal development had predominantly positive impacts on decisions about practice ownership. Factors that negatively affected considerations included work-life balance, ultimate responsibility, negative role models, unappealing practices, (un)preparedness, and issues with the process. Of note, non-practice owners felt that practice ownership could not be discussed.Conclusion: Modifications to perceived behavioural control and subjective norms are needed, together with an open dialog among GPs about practice ownership and alternative models. Our findings offer a foundation for further prospective quantitative research into efforts designed to address the shortage of practice owners in the Netherlands and other countries. This could uncover universal and country-specific themes.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The strange adolescent world that complicates general practitioner prevention: a qualitative study.

IF 2.5

BJGP Open Pub Date : 2025-03-12 DOI: 10.3399/BJGPO.2024.0290

Elodie Million, Manon Herbreteau, Gérard Bourrel, Bruno Falissard, François Carbonnel, Béatrice Lognos, Agnès Oude-Engberink

{"title":"The strange adolescent world that complicates general practitioner prevention: a qualitative study.","authors":"Elodie Million, Manon Herbreteau, Gérard Bourrel, Bruno Falissard, François Carbonnel, Béatrice Lognos, Agnès Oude-Engberink","doi":"10.3399/BJGPO.2024.0290","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0290","url":null,"abstract":"Background: Prevention is important in the international primary care system. In adolescents, several prevention areas need to be addressed: sexual health, mental health, substance use and addiction, physical activity, screen use, and social relationships... However, consultations with adolescents are complex, which puts health professionals in a difficult position. While there are professional recommendations in many countries, they focus on a single theme.Aim: To understand the preventive approaches taken by general practitioners (GPs) in consultation with adolescents.Design & setting: This preliminary qualitative study used semi-structured interviews with French GPs. Participants were recruited following direct requests and sampled using the snowball sampling method.Method: Analysis was conducted using grounded theory for the identification of conceptualizing categories.Results: Twelve interviews led to the emergence of four conceptualizing categories: 1) the characteristics of adolescents make the preventive approach complex and generate a fear of failure for GPs; 2) the world of adolescents is foreign to GPs, which hinders empathetic relationships and has a negative impact on prevention; 3) as individuals, GPs approached adolescent prevention during consultations based on their own experiences (parenthood, their own adolescence, professional practices) and interpersonal skills; and 4) GPs propose an optimized prevention approach for adolescents.Conclusion: GPs are opportunistic in terms of adolescent prevention: any occasion for consultation should be the object of a preventive action, whatever the initial motive. GPs require tools and consultations dedicated to prevention to optimize their approaches sometimes difficult. Further research about adolescents' experiences should be manage to complete GPs practical proposals.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

LDL cholesterol levels and treatment intensity in secondary prevention of patients with ischemic heart disease in the primary care setting: a real-world data registry study.

IF 2.5

BJGP Open Pub Date : 2025-03-12 DOI: 10.3399/BJGPO.2024.0220

Núria Sánchez-Ruano, Anna Fibla-Matamoros, Carles Falces, Encarna Sánchez, Antoni Sisó-Almirall, Luis González de Paz

{"title":"LDL cholesterol levels and treatment intensity in secondary prevention of patients with ischemic heart disease in the primary care setting: a real-world data registry study.","authors":"Núria Sánchez-Ruano, Anna Fibla-Matamoros, Carles Falces, Encarna Sánchez, Antoni Sisó-Almirall, Luis González de Paz","doi":"10.3399/BJGPO.2024.0220","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0220","url":null,"abstract":"Background: Monitoring LDL cholesterol (LDL-C) and prescribing appropriate treatment is crucial for secondary prevention in primary care.Aim: We studied LDL-C levels and treatments for ischemic heart disease patients according to target recommendations and assessed factors influencing prescribed drug intensity.Design & setting: We examined electronic health records of patients with ischemic heart disease from three primary care centers.Method: LDL-C levels were assessed using the most recent registry, and LDL-C-lowering treatments were categorized by their theoretical efficacy. Factors associated with LDL-C target attainment were analyzed using univariate and multivariate regression models. Prescription intensity was studied with ordinal logistic regression models.Results: We studied 1,936 patients, 14.88% of whom received no LDL-C-lowering treatment. The percentages of patients who achieved LDL-C thresholds of<70 mg/dL and<55 mg/dL were 35.0% and 12.6%, respectively. The factor associated with the<55 mg/dL threshold was type 2 diabetes mellitus (OR: 0.55, 95% CI: 0.42; 0.73), with men showing better LDL-C levels (OR: 0.34, 95% CI: 0.23; 0.51). Men had higher-intensity prescriptions (OR: 1.57, 95% CI: 1.27; 1.94), and older patients had lower-intensity treatments (OR: 0.96, 95% CI: 0.95; 0.97).Conclusion: Increased LDL-C drug treatment improvement, monitoring, and adherence to guideline recommendations are necessary for patients with ischemic heart disease. Sex and age are potential factors associated with inadequate lipid-lowering treatment intensity and poor LDL-C control, might worsen cardiovascular outcomes in high-risk patients, leading to avoidable inequity among patients who visit the primary health setting.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence and predictors of annual asthma reviews in Scottish primary care data: an observational study. 苏格兰初级医疗数据中哮喘年度复查的流行率和预测因素。

IF 2.5

BJGP Open Pub Date : 2025-03-12 DOI: 10.3399/BJGPO.2024.0062

Holly Tibble, Alexandria Ming Wai Chung

{"title":"Prevalence and predictors of annual asthma reviews in Scottish primary care data: an observational study.","authors":"Holly Tibble, Alexandria Ming Wai Chung","doi":"10.3399/BJGPO.2024.0062","DOIUrl":"10.3399/BJGPO.2024.0062","url":null,"abstract":"Background: People with asthma are recommended to have regular reviews in primary care, with assessment of symptoms, adjustment of treatment and self-management processes, and the delivery of a written action plan for emergencies.Aim: To investigate the incidence and factors associated with attendance of annual asthma reviews.Design & setting: This observational study used electronic health records for 49 307 patients in Scotland with asthma between 1 January 2000 and 31 March 2017. The analysis population of 13 726 patients had at least five asthma-related encounters between 2008 and 2016.Method: Multivariable logistic regression was employed, using linked primary care prescription data and primary care registration demographic data.Results: There was a median of 381 days between subsequent reviews. Reviews in the index year were strongly associated with reviews in the following year (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.68 to 1.84). In contrast, asthma consultations (excluding reviews) in the index year were associated with lower odds of having a review in the following year (OR 0.48, 95% CI = 0.46 to 0.51). Those aged 18-35 years in the index year or those with missing addresses in the practice registration data were the least likely groups to have an asthma review in the following year.Conclusion: Reviewing the delivery of asthma care identifies patients who may be slipping through the gaps by receiving only reactive asthma care rather than the structured, preventive care that can be delivered through annual reviews. Understanding the risk factors for not receiving an annual review can be leveraged to create more effective review invitations, such as explaining the specific content of reviews, introducing new contact methods to improve health equity, and reviewing the algorithm used to determine who is invited.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characteristics of patients with frequent contact with general practice.

IF 2.5

BJGP Open Pub Date : 2025-03-12 DOI: 10.3399/BJGPO.2024.0195

Jesper B Nielsen, Helene S Andersen

{"title":"Characteristics of patients with frequent contact with general practice.","authors":"Jesper B Nielsen, Helene S Andersen","doi":"10.3399/BJGPO.2024.0195","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0195","url":null,"abstract":"Background: Frequent attenders (more than 11 annual contacts) use more resources than most other patients in general practice.Aim: We aim to study what characterises frequent attenders related to age, gender, mode of contact (face-to-face, email, phone), and patient contact (GP or GP staff).Design & setting: We use patient data from 11 Danish GP clinics and 38.874 patients covering a 12-month period.Method: Bivariate as well as regression analyses of patient data were used.Results: Frequent attenders exist in all age groups, but with different frequencies. In the age group 55-64 years 25% of patients were frequent attenders, this increased to 33% in the next age decade from age 65-74 years and reached 48% among those above age 74 years. Frequent attenders have a different user pattern related to physical visits, phone consultations, or email consultations than other patients. In their contact to the GP clinic, the frequent attender is relatively more often in contact with the practice staff than a GP compared to other patients.Conclusion: Within our Danish patient population,22% had more than 11 annual contacts to their GP clinic. These frequent attenders are in general terms characterized by being women, above 65 years of age, having 20 annual contacts to the GP clinic, and having plus 10 diagnoses. For the entire patient population, the GP handles 40% of the patient contacts (60% by other staff members), and this percentage is lowest among frequent attenders. E-mail contact is more frequent among frequent attenders than other patients.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The impact of paramedics working in primary care teams on other professionals and patient experiences: a qualitative study.

IF 2.5

BJGP Open Pub Date : 2025-03-12 DOI: 10.3399/BJGPO.2024.0152

Georgette Eaton, Stephanie Tierney, Geoff Wong, Veronika Williams, Julia Williams, Kamal R Mahtani

{"title":"The impact of paramedics working in primary care teams on other professionals and patient experiences: a qualitative study.","authors":"Georgette Eaton, Stephanie Tierney, Geoff Wong, Veronika Williams, Julia Williams, Kamal R Mahtani","doi":"10.3399/BJGPO.2024.0152","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0152","url":null,"abstract":"Background: Paramedics are among the professional groups identified in recent policy initiatives aimed at addressing the unsustainable workload and workforce crises in primary care. Their support aims to enhance patient access to care and alleviate the burden of workload pressures.Aim: To explore the impact of paramedics working in primary care on primary care teams and the experiences of patients who have a clinical consultation with a paramedic in primary care.Design & setting: Focused observations and interviews involving fifteen geographically dispersed sites across the United Kingdom.Method: Data were collected between May 2022 and January 2023, incorporating 60 semi-structured interviews and 60 hours of observations of paramedics. Transcripts were thematically analysed.Results: Patients, GPs and other staff in primary care perceive that the paramedic role enhances healthcare availability in primary care by increasing workforce capacity. This is especially prevalent when paramedics work in a clinical capacity that complements the GP role. However, successful integration into the primary care team relies on paramedics having significant clinical experience and receiving clinical supervision from GPs. Patients are trusting of the paramedic role when they have positive clinical consultations.Conclusion: Paramedics have potential to improve access to the primary care workforce. However, attention to supportive transition processes (such as clinical supervision) are required for the paramedic to successfully be integrated into the primary care team.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lyme disease in UK primary care: a knowledge, attitude, and practice survey. 英国初级保健中的莱姆病：知识、态度和实践调查。

IF 2.5

BJGP Open Pub Date : 2025-03-12 DOI: 10.3399/BJGPO.2024.0092

Lucy Delaney, Amanda Semper, Neil French, John Sp Tulloch

{"title":"Lyme disease in UK primary care: a knowledge, attitude, and practice survey.","authors":"Lucy Delaney, Amanda Semper, Neil French, John Sp Tulloch","doi":"10.3399/BJGPO.2024.0092","DOIUrl":"10.3399/BJGPO.2024.0092","url":null,"abstract":"Background: Lyme disease (LD) cases in the UK most commonly present within the primary care setting. Despite an upward trend of incidence, little is known regarding GP experience with diagnosis and treatment.Aim: This study aims to describe baseline primary care clinician Knowledge, Attitude and Practice (KAP) in Scotland and England.Design & setting: Online KAP survey on LD for UK-based practising GPs.Method: An online KAP questionnaire was developed for use in UK primary care. The survey was distributed through UK-based research networks, professional societies, and via social media.Results: A total of 191 complete responses were analysed (England n = 130, Scotland n = 61). The Scotland-based responder group had more relevant consultations in the previous 3 years. Responders from Scotland demonstrated a greater awareness that erythema migrans (EM) is pathognomonic for LD and that serological testing of this patient group is not indicated. Less common cardiac and neurological symptoms were not as well associated with LD by both responder groups for the former and England-based responders for the latter. Prescribing according to the National institute for Health and Care Excellence (NICE) guidance was identified in 70% of Scotland and 42% of England-based GP responses.Conclusion: Targeted resources may improve clinician confidence on exposure risk, symptom recognition, testing limitations and treatment dose and duration. Scotland-based responders' better survey performance potentially reflects greater clinical exposure and public awareness of the disease, due to high endemicity within the nation.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Chronic pain - prevalence, demographic inequalities and healthcare utilisation: a primary care database analysis.

IF 2.5

BJGP Open Pub Date : 2025-02-27 DOI: 10.3399/BJGPO.2024.0147

Siddesh Shetty, James Scuffell, Dianne Aitken, Mark Ashworth

{"title":"Chronic pain - prevalence, demographic inequalities and healthcare utilisation: a primary care database analysis.","authors":"Siddesh Shetty, James Scuffell, Dianne Aitken, Mark Ashworth","doi":"10.3399/BJGPO.2024.0147","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0147","url":null,"abstract":"Background: Chronic pain (CP) is an ill-defined condition, often under-recorded in primary care records.Aim: To determine prevalence, evidence of health inequalities, primary care consultation rates and healthcare utilisation costs of CP.Design & setting: Cross-sectional, retrospective study using anonymised primary care data from all GP practices in one inner-city London area.Method: CP was defined on the basis of analgesic medication codes and novel inclusion of diagnostic codes for conditions known to be strongly associated with CP. CP prevalence and consultation rates were determined; comparisons were made with 31 other Long-Term Condition (LTCs). Consultation cost estimates were based on health care professional type and consultation mode.Results: 358 889 adult patients were registered in sample practices, with continuous (12-month) health care records available for 327 800 (91.3%). CP prevalence was 18.6%; the second most prevalent LTC after anxiety at 21.4%. CP mean annual consultation rates were 15.3/patient, the highest LTC consultation rate. CP incurred the highest primary care consultation costs of any of the included LTCs. Age was the strongest predictor of CP, particularly in those aged≥60 years (Adjusted Odds Ratio (AOR): 9.32; 95% Confidence Interval: 8.83 to 9.84; compared to 18-39-year-olds). Much smaller AORs were found for ethnicity, social deprivation, gender and non-UK country of birth.Conclusion: CP represents the most demanding LTC, in terms of consultation rates and costs, managed in primary care. Yet there is considerable uncertainty about optimal management and alternatives to long term, high volume primary care consultation rates.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

GP referral to rapid diagnostic centres for non-specific cancer symptoms: a qualitative study.

IF 2.5

BJGP Open Pub Date : 2025-02-27 DOI: 10.3399/BJGPO.2024.0179

Caroline White, Spencer Robinson, Una Macleod, Charlotte Kelly

{"title":"GP referral to rapid diagnostic centres for non-specific cancer symptoms: a qualitative study.","authors":"Caroline White, Spencer Robinson, Una Macleod, Charlotte Kelly","doi":"10.3399/BJGPO.2024.0179","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0179","url":null,"abstract":"Background: Diagnosing cancer can be challenging, especially when patients present to General Practitioners (GPs) with serious, but nonspecific symptoms. Rapid Diagnostic Centres (RDCs) have been introduced in England as diagnostic pathways for patients with non-specific symptoms where cancer is suspected, but they do not meet existing cancer pathway criteria.Aim: To investigate GP perspectives on referral to an RDC pathway for patients with non-specific symptoms and suspected cancer.Design & setting: Semi-structured interviews with GPs within the catchment area of an acute NHS Trust METHOD: GP interviews focusing on experiences of using the RDC pathway. A thematic analysis was conducted on interview transcripts.Results: GPs reported the RDC pathway as a game changer. It offered faster referral, reduced anxiety for GPs and patients, and reduced the need for GPs to 'game the system' when patients do not meet criteria for cancer-specific pathways. The narrative required on referral appeared to legitimise GP gut feelings and expertise. RDC results (if not cancer) gave GPs space to treat patients without concern of a missed cancer, while ensuring onward referral for those with cancer or other serious conditions. Some access barriers, especially related to travel and time, were identified especially for patients in rural areas.Conclusion: This cancer pathway fills a referral gap for GPs and patients with non-specific potential cancer symptoms. It has an important signposting function, helping identify patients requiring treatment for cancer/other serious conditions, and others whose symptoms can be treated safely within primary care.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Developing a data-enabled nudge intervention for childhood antibiotics in primary care: a qualitative study. 在初级保健中开发针对儿童抗生素的数据支持干预措施：一项定性研究。

IF 2.5

BJGP Open Pub Date : 2025-02-25 DOI: 10.3399/BJGPO.2024.0032

Oliver Van Hecke, Aleksandra Borek, Christopher Butler, Sarah Tonkin-Crine

{"title":"Developing a data-enabled nudge intervention for childhood antibiotics in primary care: a qualitative study.","authors":"Oliver Van Hecke, Aleksandra Borek, Christopher Butler, Sarah Tonkin-Crine","doi":"10.3399/BJGPO.2024.0032","DOIUrl":"10.3399/BJGPO.2024.0032","url":null,"abstract":"Background: Preschool children (aged ≤5 years) have the highest antibiotic prescribing rate in general practice, mostly for self-limiting acute respiratory tract infections (RTIs). Research from >250 000 UK children suggests that a child's antibiotic history for RTI may be a good predictor for re-consulting a health professional for the same illness episode and increased clinical workload.Aim: To develop a data-enabled nudge intervention to optimise antibiotic prescribing for acute RTI based on a child's antibiotic history in general practice.Design & setting: Two-phase qualitative study with parents or carers of preschool children and primary care clinicians in England.Method: In phase 1, through an initial focus group with eight parents or carers and 'think-aloud' interviews with 11 clinicians, we co-designed the intervention (computer-screen prompt and personalised consultation leaflet). In phase 2, 13 clinicians used the intervention, integrated into the GP computer software, and shared their feedback through 'think-aloud' interviews. Interviews were audio-recorded, transcribed, and analysed thematically.Results: We co-created a data-driven intervention that automatically integrates a child's antibiotic history for acute RTI and personalised leaflet into the electronic medical records. We found that parents and clinicians found this intervention, in principle, acceptable and feasible to use in primary care consultations. GP participants reflected on the prompt's novelty and its usefulness of taking stock of the number of antibiotic prescriptions a child has had in the past year.Conclusion: Delivering such interventions, integrated into practice workflow, could be efficiently scaled up to promote effective antimicrobial stewardship and reduce unnecessary antibiotic use in primary care. Further research will test this intervention in a future trial.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0