January 2016 New Study On Antibiotic Prescribing and Consumption for Urinary Tract Infections

NUI Galway researchers study the culture of antibiotic prescribing and consumption for Urinary Tract Infections and find the need for more dialogue among GPs and Patients

Researchers from NUI Galway’s School of Medicine have carried out a study to explore the culture of antibiotic prescribing and consumption in the community for Urinary Tract Infections (UTIs), from the perspective of the General Practitioners (GPs) and community members. Their results were published in the medical journal BMJ Open.

This research provides insight into the decision-making processes contributing to the continued prescription and consumption of antibiotics for Urinary Tract Infections. An antibiotic is not a satisfactory outcome from every UTI GP consultation.
As a result of this qualitative research, behavioural interventions should focus on:

• Improving the quality of antibiotic prescribing for UTI by encouraging GPs to reflect on their current antibiotic-prescribing practices, including when they prescribe and what antibiotics they choose.
• Supporting a dialogue between the GP and the patient within the consultation about the positive and negative aspects of antibiotic treatment for UTI particularly when symptoms are non-specific.
• Building changes into routine care without elongating the consultation.

As part of the study the NUI Galway researchers carried out in depth interviews with 15 GPs practicing in rural and urban locations in Ireland, and six focus groups were held with community members who had direct or indirect experiences with urinary tract infection.

The study found that decisions made to prescribe or consume an antibiotic for a UTI is a set of complex processes. It includes recognising that you are unwell (need recognition), seeking advice from various sources like the web and family members prior to visiting the GP (information search), and deciding whether to go to the GP (evaluation process). All of these processes are governed by the relationship and interactions between the GP and the patient.

Different GP and patient decision-making profiles emerged, emphasising the diversity and variety of general practice in real-life settings. The GP findings showed a requirement for more microbiological information on antibiotic resistance patterns to inform prescribing decisions. Focus group participants (patients) wanted a conversation with the GP about their illness and the treatment options available.

Dr Sinead Duane from the School of Medicine at NUI Galway and co-author of the study said: “Many patients are open to delaying antibiotic treatment if the GP takes time to explain the reasons why and provides advice on which symptoms they should look out for. This research highlights that patients visiting their GP often only want reassurance and advice on how to manage their symptom, and not necessarily an antibiotic.”

Collectively, this research identified the consultation as a priority intervention environment for stimulating change in relation to antibiotics. The BMJ Open paper demonstrates how qualitative research can identify the interacting processes which are instrumental to the decision to prescribe or consume an antibiotic for a suspected UTI.

Qualitative research empowers researchers to investigate the what, how and why of interventions in a real-life setting. Qualitative research can play a critical and instrumental role in designing behavioural change strategies with high impact on practice. The results of this research were used to design a complex intervention informed by social marketing.

To view the full BMJ Open paper visit: http://bmjopen.bmj.com/content/6/1/e008894.full.pdf+html

ENDS