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Infectious Disease and Primary Care Research-What English General Practitioners Say They Need
Donna M Lecky1, Steve Granier2, Rosalie Allison1
1Primary Care and Interventions Unit, Public Health England, Gloucester GL1 1DQ, UK.
Background:
Infections are one of the most common reasons for patients attending primary care. Antimicrobial resistance (AMR) is perhaps one of the biggest threats to modern medicine; data show that 81% of antibiotics in the UK are prescribed in primary care.
Aim:
To identify where the perceived gaps in knowledge, skills, guidance and research around infections and antibiotic use lie from the general practitioner (GP) viewpoint.
Design And Setting:
An online questionnaire survey.
Method:
The survey, based on questions asked of Royal College of General Practitioners (RCGP) members in 1999, and covering letter were electronically sent to GPs between May and August 2017 via various primary care dissemination routes.
Results:
Four hundred and twenty-eight GPs responded. Suspected Infection in the elderly, recurrent urinary tract infection (UTI), surveillance of AMR in the community, leg ulcers, persistent cough and cellulitis all fell into the top six conditions ranked in order of importance that require further research, evidence and guidance. Acute sore throat, otitis media and sinusitis were of lower importance than in 1999.
Conclusion:
This survey will help the NHS, the UK National Institute for Health and Care Excellence (NICE) and researchers to prioritise for the development of guidance and research for chronic conditions highlighted for which there is little evidence base for diagnostic and management guidelines in primary care. In contrast, 20 years of investment into research, guidance and resources for acute respiratory infections have successfully reduced these as priority areas for GPs.
Insights
General practitioners (GPs) identified key research gaps in managing elderly infections, recurrent urinary tract infections (UTIs), and community antimicrobial resistance (AMR). This contrasts with reduced focus on acute respiratory infections due to prior investment.
Area of Science:
- Primary care medicine
- Infectious diseases
- Antimicrobial stewardship
Background:
- Infections are a leading reason for primary care visits.
- Antimicrobial resistance (AMR) poses a significant threat, with 81% of UK antibiotics prescribed in primary care.
- General practitioners (GPs) are central to antibiotic prescribing and infection management.
Purpose of the Study:
- To identify perceived gaps in knowledge, skills, guidance, and research concerning infections and antibiotic use from a GP perspective.
- To understand current GP priorities in infection management and antimicrobial stewardship.
- To inform future research and guideline development in primary care.
Main Methods:
- An online questionnaire survey was distributed to GPs.
- The survey was electronically sent to GPs between May and August 2017.
- Questions were based on a 1999 Royal College of General Practitioners (RCGP) survey.
Main Results:
- 428 GPs responded to the survey.
- Top research priorities included suspected infections in the elderly, recurrent urinary tract infections (UTIs), community AMR surveillance, leg ulcers, persistent cough, and cellulitis.
- Acute sore throat, otitis media, and sinusitis were identified as lower priorities compared to 1999.
Conclusions:
- The findings will guide the NHS, NICE, and researchers in prioritizing guidance and research for chronic conditions lacking evidence.
- Significant investment in research for acute respiratory infections has successfully reduced their priority status for GPs.
- Addressing identified gaps can improve primary care management of infections and combat AMR.
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