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General Practitioners' Attitudes toward Municipal Initiatives to Improve Antibiotic Prescribing-A Mixed-Methods Study
Marthe Sunde1, Marthe Marie Nygaard1, Sigurd Høye2
1Faculty of Medicine, University of Oslo, 0318 Oslo, Norway.
Abstract:
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.
Insights
General practitioners (GPs) sometimes prescribe antibiotics without medical need, often due to patient pressure. Involving Municipal Chief Medical Officers (MCMOs) in antimicrobial stewardship initiatives is viewed positively by GPs for improving antibiotic prescribing practices.
Area of Science:
- Public Health
- General Practice
- Infectious Disease Epidemiology
Background:
- Antimicrobial stewardship (AMS) interventions are crucial for optimizing antibiotic prescribing in general practice.
- Implementing and sustaining national-level AMS programs presents significant challenges.
- Municipal Chief Medical Officers (MCMOs) can potentially facilitate AMS interventions, but their role may be perceived as challenging by GPs.
Purpose of the Study:
- To explore General Practitioners' (GPs) perspectives on their antibiotic prescribing habits.
- To assess GPs' views on the involvement of Municipal Chief Medical Officers (MCMOs) in improving antibiotic prescribing.
- To evaluate the feasibility and acceptance of MCMO-facilitated AMS interventions in primary care.
Main Methods:
- Mixed-methods study combining qualitative (e-mail interviews) and quantitative (online surveys) data.
- Data collected from 15 GPs pre-intervention and 132 GPs during the ENORM study.
- Qualitative data analyzed using systematic text condensation.
Main Results:
- GPs acknowledged occasional antibiotic overprescribing, citing patient pressure and liberal treatment guidelines.
- MCMOs were perceived as suitable and acceptable facilitators for quality improvement activities (mean acceptability 8.2/10).
- GPs recognized the need for improved antibiotic prescribing and welcomed municipal engagement.
Conclusions:
- GPs are open to improving their antibiotic prescribing and view MCMOs as valuable partners in AMS.
- Involving MCMOs in quality improvement initiatives can effectively support AMS in general practice.
- Municipal engagement is recommended for enhancing antimicrobial stewardship in primary care settings.