scholarly journals Impact of the COVID-19 Pandemic on Community Antibiotic Prescribing and Stewardship: A Qualitative Interview Study with General Practitioners in England

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1531
Author(s):  
Aleksandra J. Borek ◽  
Katherine Maitland ◽  
Monsey McLeod ◽  
Anne Campbell ◽  
Benedict Hayhoe ◽  
...  
Keyword(s):  
General Practitioners ◽  
Respiratory Infections ◽  
Qualitative Interview ◽  
Antibiotic Prescribing ◽  
Skin Infections ◽  
Structured Interviews ◽  
Care Services ◽  
Primary Care Services ◽  
Qualitative Interview Study ◽  
Longitudinal Approach

The COVID-19 pandemic has had a profound impact on the delivery of primary care services. We aimed to identify general practitioners’ (GPs’) perceptions and experiences of how the COVID-19 pandemic influenced antibiotic prescribing and antimicrobial stewardship (AMS) in general practice in England. Twenty-four semi-structured interviews were conducted with 18 GPs at two time-points: autumn 2020 (14 interviews) and spring 2021 (10 interviews). Interviews were audio-recorded, transcribed and analysed thematically, taking a longitudinal approach. Participants reported a lower threshold for antibiotic prescribing (and fewer consultations) for respiratory infections and COVID-19 symptoms early in the pandemic, then returning to more usual (pre-pandemic) prescribing. They perceived the pandemic as having had less impact on antibiotic prescribing for urinary and skin infections. Participants perceived the changing ways of working and consulting (e.g., proportions of remote and in-person consultations) in addition to changing patient presentations and GP workloads as influencing the fluctuations in antibiotic prescribing. This was compounded by decreased engagement with, and priority of, AMS due to COVID-19-related urgent priorities. Re-engagement with AMS is needed, e.g., through reviving antibiotic prescribing feedback and targets/incentives. The pandemic disrupted, and required adaptations in, the usual ways of working and AMS. It is now important to identify opportunities, e.g., for re-organising ways of managing infections and AMS in the future.

scholarly journals Impact of the COVID-19 pandemic on community antibiotic prescribing and stewardship: a qualitative interview study with general practitioners in England

2021 ◽  
Author(s):  
Aleksandra J Borek ◽  
Katherine Maitland ◽  
Monsey Mcleod ◽  
Anne Campbell ◽  
Benedict Hayhoe ◽  
...  
Keyword(s):  
General Practitioners ◽  
Respiratory Infections ◽  
Qualitative Interview ◽  
Antibiotic Prescribing ◽  
Skin Infections ◽  
Structured Interviews ◽  
Care Services ◽  
Primary Care Services ◽  
Qualitative Interview Study ◽  
Longitudinal Approach

The COVID-19 pandemic has had a profound impact on the delivery of primary care services. We aimed to identify general practitioners (GPs) perceptions and experiences of how the COVID-19 pandemic influenced antibiotic prescribing and antimicrobial stewardship (AMS) in general practice in England. Twenty-four semi-structured interviews were conducted with 18 GPs at two time-points: autumn 2020 (14 interviews) and spring 2021 (10 interviews). Interviews were audio-recorded, transcribed and analysed thematically, taking a longitudinal approach. Participants reported a lower threshold for antibiotic prescribing (and fewer consultations) for respiratory infections and COVID-19 symptoms early in the pandemic, then returning to more usual (pre-pandemic) prescribing. They perceived less impact on antibiotic prescribing for urinary and skin infections. Participants perceived the changing ways of working and consulting (e.g., proportions of remote and in-person consultations), and the changing patient presentations and GP workload as influencing the fluctuations in antibiotic prescribing. This was compounded by decreased engagement with, and priority of, AMS due to COVID-19-related urgent priorities. Re-engagement with AMS is needed, e.g., through reviving antibiotic prescribing feedback and targets/incentives. While the pandemic disrupted the usual ways of working, it also produced opportunities, e.g., for re-organising ways of managing infections and AMS in the future.

scholarly journals Parents and GPs’ understandings and beliefs about food allergy testing in children with eczema: qualitative interview study within the Trial of Eczema allergy Screening Tests (TEST) feasibility trial

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041229
Author(s):  
Clare Clement ◽  
Matthew J Ridd ◽  
Kirsty Roberts ◽  
Miriam Santer ◽  
Robert Boyle ◽  
...  
Keyword(s):  
Decision Making ◽  
Food Allergy ◽  
Qualitative Interview ◽  
Interview Study ◽  
Screening Tests ◽  
Feasibility Trial ◽  
Structured Interviews ◽  
Allergy Testing ◽  
Qualitative Interview Study ◽  
Severe Eczema

AimTo explore parent and general practitioner (GP) understanding and beliefs about food allergy testing for children with eczema.Design and settingQualitative interview study in UK primary care within the Trial of Eczema allergy Screening Tests feasibility trial.ParticipantsSemi-structured interviews with parents of children with eczema taking part in the feasibility study and GPs at practices hosting the study.Results21 parents and 11 GPs were interviewed. Parents discussed a range of potential causes for eczema, including a role for food allergy. They believed allergy testing to be beneficial as it could potentially identify a cure or help reduce symptoms and they found negative tests reassuring, suggesting to them that no dietary changes were needed. GPs reported limited experience and uncertainty regarding food allergy in children with eczema. While some GPs believed referral for allergy testing could be appropriate, most were unclear about its utility. They thought it should be reserved for children with severe eczema or complex problems but wanted more information to advise parents and help guide decision making.ConclusionsParents’ motivations for allergy testing are driven by the desire to improve their child’s condition and exclude food allergy as a possible cause of symptoms. GPs are uncertain about the role of allergy testing and want more information about its usefulness to support parents and help inform decision making.Trial registration numberISRCTN15397185.

scholarly journals Experiences of patients and physiotherapists with blended internet-based vestibular rehabilitation: a qualitative interview study

BJGP Open ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. bjgpopen20X101092
Author(s):  
Vincent A van Vugt ◽  
Anja JThCM de Kruif ◽  
Johannes C van der Wouden ◽  
Henriëtte E van der Horst ◽  
Otto R Maarsingh
Keyword(s):  
Controlled Trial ◽  
Randomised Trial ◽  
Qualitative Interview ◽  
Vestibular Rehabilitation ◽  
Interview Study ◽  
Structured Interviews ◽  
Qualitative Interview Study ◽  
Vestibular Symptoms ◽  
Randomised Controlled

BackgroundInternet-based vestibular rehabilitation (VR) with physiotherapy support, known as blended VR, was effective in reducing vestibular symptoms in a recent randomised controlled trial. Blended VR is a complex intervention comprised of physiotherapeutic visits, the vertigo training website, and VR exercises. Because of these interacting components, it is important to understand how blended VR works, for whom it works best, and how it should ideally be delivered.AimTo investigate the experiences of both patients and physiotherapists with blended internet-based VR.Design & settingA qualitative interview study was performed with patients who received blended internet-based VR with physiotherapy support, and physiotherapists who provided this support.MethodSemi-structured interviews were conducted with 14 patients and eight physiotherapists after the 6-month follow-up of the randomised trial. All interviews were audio-recorded, transcribed, and thematically analysed.ResultsAccording to both patients and physiotherapists, the physiotherapist visits were useful in providing personal attention, helping patients safely execute exercises, and improving patients’ adherence to therapy. Some patients said they did not need physiotherapist support and, according to physiotherapists, both the necessity and the optimal way to deliver guidance differed greatly between patients. The Vertigo Training website and exercises provided patients with a sense of control over their symptoms. Patients reported that the VR exercises were easy to perform and most patients continued to use them long after the trial ended.ConclusionIn blended VR, physiotherapeutic visits appear to offer benefits above the vertigo training website and VR exercises alone. Physiotherapy support may best be used when individually tailored.

scholarly journals Maintaining face-to-face contact during the COVID-19 pandemic: a longitudinal qualitative investigation in UK primary care

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0036
Author(s):  
Andrew Turner ◽  
Anne Scott ◽  
Jeremy Horwood ◽  
Chris Salisbury ◽  
Rachel Denholm ◽  
...  
Keyword(s):  
Qualitative Interview ◽  
Infection Risk ◽  
Qualitative Investigation ◽  
Structured Interviews ◽  
Face To Face ◽  
Outdoor Spaces ◽  
National Guidance ◽  
Qualitative Interview Study ◽  
General Practices ◽  
Indoor And Outdoor

BackgroundIn March 2020 the COVID-19 pandemic required a rapid reconfiguration of UK general practice to minimise face-to-face contact with patients to reduce infection risk. However, some face-to-face contact remained necessary and practices needed to ensure such contact could continue safely.AimTo examine how practices determined when face-to-face contact was necessary and how face-to-face consultations were reconfigured to reduce COVID-19 infection risk.Design & settingQualitative interview study in general practices in Bristol, North Somerset and South Gloucestershire.MethodLongitudinal semi-structured interviews with clinical and managerial practice staff at four timepoints between May and July 2020.ResultsPractices worked flexibly within general national guidance to determine when face-to-face contact with patients was necessary, influenced by knowledge of the patient, experience, and practice resilience. For example, practices prioritised patients according to clinical need using face-to-face contact to resolve clinician uncertainty or provide adequate reassurance to patients. To make face-to-face contact as safe as possible and keep patients separated, practices introduced a heterogeneous range of measures that exploited features of their indoor and outdoor spaces and altered their appointment processes. As national restrictions eased in June and July, the number and proportion of patients seen face-to-face generally increased. However, the reconfiguration of buildings and processes reduced the available capacity and put increased pressure on practices.ConclusionPractices responded rapidly and creatively to the initial lockdown restrictions. The variety of ways practices organised face-to-face contact to minimise infection highlights the need for flexibility in guidance.

scholarly journals General Practitioners� Perspective on eHealth and Lifestyle Change: Qualitative Interview Study

2017 ◽  
Author(s):  
Carl Joakim Brandt ◽  
Gabrielle Isidora S�gaard ◽  
Jane Clemensen ◽  
Jens Sndergaard ◽  
Jesper Bo Nielsen
Keyword(s):  
General Practitioners ◽  
Lifestyle Change ◽  
Qualitative Interview ◽  
Interview Study ◽  
Qualitative Interview Study
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