Home self-administration of intravenous antibiotics as part of an outpatient parenteral antibiotic therapy service: a qualitative study of the perspectives of patients who do not self-administer.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
25 01 2019
Historique:
entrez: 21 2 2019
pubmed: 21 2 2019
medline: 20 2 2020
Statut: epublish

Résumé

This study aimed to use a theoretical approach to understand the determinants of behaviour in patients not home self-administering intravenous antibiotics. Outpatient care: included patients were attending an outpatient clinic for intravenous antibiotic administration in the northeast of Scotland. Patients were included if they had received more than 7 days of intravenous antibiotics and were aged 16 years and over. Twenty potential participants were approached, and all agreed to be interviewed. 13 were male with a mean age of 54 years (SD +17.6). Key behavioural determinants that influenced patients' behaviours relating to self-administration of intravenous antibiotics. Qualitative, semistructured in-depth interviews were undertaken with a purposive sample of patients. An interview schedule, underpinned by the Theoretical Domains Framework (TDF), was developed, reviewed for credibility and piloted. Interviews were audio-recorded and transcribed verbatim. Data were analysed thematically using the TDF as the coding framework. The key behavioural determinants emerging as encouraging patients to self-administer intravenous antibiotics were the perceptions of being sufficiently knowledgeable, skilful and competent and that self-administration afforded the potential to work while administering treatment. The key determinants that impacted their decision not to self-administer were lack of knowledge of available options, a perception that hospital staff are better trained and anxieties of potential complications. Though patients are appreciative of the skills and knowledge of hospital staff, there is also a willingness among patients to home self-administer antibiotics. However, the main barrier emerges to be a perceived lack of knowledge of ways of doing this at home. To overcome this, a number of interventions are suggested based on evidence-based behavioural change techniques.

Identifiants

pubmed: 30782762
pii: bmjopen-2018-027475
doi: 10.1136/bmjopen-2018-027475
pmc: PMC6347967
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e027475

Informations de copyright

© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Antonella Tonna (A)

School of Pharmacy and Life Sciences, The Robert Gordon University, Aberdeen, UK.

Geraldine Anthony (G)

School of Pharmacy and Life Sciences, The Robert Gordon University, Aberdeen, UK.

Ivan Tonna (I)

Infectious Diseases, Aberdeen Royal Infirmary, Aberdeen, UK.

Vibhu Paudyal (V)

Centre of Academic Primary Care, University of Birmingham, Birmingham, UK.

Katrina Forbes-McKay (K)

School of Applied Social Studies, Robert Gordon University, Aberdeen, UK.

Rob Laing (R)

Infectious Diseases, Aberdeen Royal Infirmary, Aberdeen, UK.

Alexander Mackenzie (A)

Infectious Diseases, Aberdeen Royal Infirmary, Aberdeen, UK.

Sharon Falconer (S)

Infectious Diseases, Aberdeen Royal Infirmary, Aberdeen, UK.

Gillian McCartney (G)

Infectious Diseases, Aberdeen Royal Infirmary, Aberdeen, UK.

Derek Stewart (D)

School of Pharmacy and Life Sciences, The Robert Gordon University, Aberdeen, UK.

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Classifications MeSH