Family doctors' roles and perceptions on antibiotic consumption and antibiotic resistance in Romania: a qualitative study.

Antibiotic resistance Antimicrobial resistance Family doctors General practitioners Perceptions Roles Romania

Journal

BMC primary care
ISSN: 2731-4553
Titre abrégé: BMC Prim Care
Pays: England
ID NLM: 9918300889006676

Informations de publication

Date de publication:
10 04 2023
Historique:
received: 26 06 2022
accepted: 27 03 2023
medline: 12 4 2023
entrez: 10 4 2023
pubmed: 11 4 2023
Statut: epublish

Résumé

Antimicrobial resistance (AMR) is a major global health issue, bringing significant health burden and costs to societies. Increased antibiotic consumption (ABC) is linked to AMR emergence. Some of the known drivers of ABC are antibiotics over-prescription by physicians and their misuse by patients. Family doctors are recognised as important stakeholders in the control of ABC as they prescribe antibiotics and are considered a reliable source of medical information by patients. Therefore, it is important to explore their perceptions, especially in Romania, which has the highest ABC among European Union Member States. Furthermore, there is no published research exploring Romanian family doctors' perceptions regarding this phenomenon. This was a qualitative study with data collection via semi-structured interviews among 12 family doctors. Manifest and latent content analysis was used to gain an in-depth understanding of their perceptions. Findings were mapped onto the domains of the Behaviour Change Wheel to facilitate a theory driven systematization and analysis. Two main subthemes emerged: i) factors affecting ABC and prescribing and ii) potential interventions to tackle ABC and antibiotic resistance. The factors were further grouped in those that related to the perceived behaviour of family doctors or patients as well as those that had to do with the various systems, local contexts and the COVID-19 pandemic. An overarching theme: 'family doctors in Romania see their role differently when it comes to antibiotic resistance and perceive the lack of patient education or awareness as one of the major drivers of ABC' was articulated. The main findings suggested that the perceived factors span across the capability, opportunity and motivational domains of the behaviour change wheel and could be addressed through a variety of interventions - some identified by the participants. Findings can also be viewed through cultural lenses which shed further light on the family doctor- patient dynamic when it comes to antibiotics use. Potential interventions to tackle identified factors emerged, revolving mostly on efforts to educate patients or the public. This exploratory research provides key perspectives and facilitates further research on potential interventions to successfully address AMR in Romania or similar settings.

Sections du résumé

BACKGROUND
Antimicrobial resistance (AMR) is a major global health issue, bringing significant health burden and costs to societies. Increased antibiotic consumption (ABC) is linked to AMR emergence. Some of the known drivers of ABC are antibiotics over-prescription by physicians and their misuse by patients. Family doctors are recognised as important stakeholders in the control of ABC as they prescribe antibiotics and are considered a reliable source of medical information by patients. Therefore, it is important to explore their perceptions, especially in Romania, which has the highest ABC among European Union Member States. Furthermore, there is no published research exploring Romanian family doctors' perceptions regarding this phenomenon.
METHODS
This was a qualitative study with data collection via semi-structured interviews among 12 family doctors. Manifest and latent content analysis was used to gain an in-depth understanding of their perceptions. Findings were mapped onto the domains of the Behaviour Change Wheel to facilitate a theory driven systematization and analysis.
RESULTS
Two main subthemes emerged: i) factors affecting ABC and prescribing and ii) potential interventions to tackle ABC and antibiotic resistance. The factors were further grouped in those that related to the perceived behaviour of family doctors or patients as well as those that had to do with the various systems, local contexts and the COVID-19 pandemic. An overarching theme: 'family doctors in Romania see their role differently when it comes to antibiotic resistance and perceive the lack of patient education or awareness as one of the major drivers of ABC' was articulated. The main findings suggested that the perceived factors span across the capability, opportunity and motivational domains of the behaviour change wheel and could be addressed through a variety of interventions - some identified by the participants. Findings can also be viewed through cultural lenses which shed further light on the family doctor- patient dynamic when it comes to antibiotics use.
CONCLUSION
Potential interventions to tackle identified factors emerged, revolving mostly on efforts to educate patients or the public. This exploratory research provides key perspectives and facilitates further research on potential interventions to successfully address AMR in Romania or similar settings.

Identifiants

pubmed: 37038124
doi: 10.1186/s12875-023-02047-z
pii: 10.1186/s12875-023-02047-z
pmc: PMC10084585
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

93

Informations de copyright

© 2023. The Author(s).

Références

Infect Drug Resist. 2019 Oct 31;12:3385-3396
pubmed: 31802918
Int J Antimicrob Agents. 2002 Dec;20(6):399-406
pubmed: 12458132
Medicina (Kaunas). 2020 Jun 25;56(6):
pubmed: 32630388
J Antimicrob Chemother. 2010 Dec;65(12):2674-84
pubmed: 20956353
BMC Health Serv Res. 2008 Jun 06;8:123
pubmed: 18538009
Int J Antimicrob Agents. 2013 Mar;41(3):203-12
pubmed: 23127482
JAC Antimicrob Resist. 2022 Feb 07;4(1):dlac007
pubmed: 35156031
J Eval Clin Pract. 2012 Apr;18(2):473-84
pubmed: 21210896
Health Policy Plan. 2021 Jun 3;36(5):594-605
pubmed: 33822953
Rev Med Chir Soc Med Nat Iasi. 2014 Jan-Mar;118(1):160-4
pubmed: 24741793
Perspect Public Health. 2021 Jan;141(1):19-27
pubmed: 31633458
J Antimicrob Chemother. 2006 Feb;57(2):326-30
pubmed: 16387751
Med Decis Making. 2022 Apr;42(3):303-312
pubmed: 35021900
J Antimicrob Chemother. 2017 Apr 1;72(4):975-987
pubmed: 27999058
PeerJ. 2017 Sep 12;5:e3803
pubmed: 28924507
Health Econ Rev. 2021 Aug 9;11(1):29
pubmed: 34370115
Implement Sci. 2011 Apr 23;6:42
pubmed: 21513547
J Pharm Policy Pract. 2016 Mar 31;9:10
pubmed: 27042313
Int J Environ Res Public Health. 2018 Dec 23;16(1):
pubmed: 30583571

Auteurs

Ioana Ghiga (I)

Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden. ioana.ghiga@ki.se.

Emma Pitchforth (E)

Primary Care Research Group, University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.

Cecilia Stålsby Lundborg (C)

Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden.

Anna Machowska (A)

Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden.

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Classifications MeSH