Influences on antibiotic prescribing by non-medical prescribers for respiratory tract infections: A systematic review using the Theoretical Domains Framework

Angel Chater, Hannah Family, Rosemary Lim, Molly Courtenay

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Background
The need to conserve antibiotic sensitivity through the management of respiratory tract infections (RTIs) without recourse to antibiotics, is a global priority. A key target for interventions is the antibiotic prescribing behaviour of healthcare professionals including non-medical prescribers (NMPs: nurses, pharmacists, paramedics, physiotherapists) who manage these infections.

Aim
To identify what evidence exists regarding the influences on NMPs antimicrobial prescribing behaviour and analyse the operationalisation of the identified drivers of behaviour using the Theoretical Domains Framework (TDF).

Methods
The search strategy was applied across 6 electronic bibliographic databases (eligibility criteria included original studies; written in English and published before July 2019; non-medical prescribers as participants; and looked at influences on prescribing patterns, of antibiotics for respiratory tract infections). Study characteristics, influences on appropriate antibiotic prescribing and intervention content to enhance appropriate antibiotic prescribing were independently extracted and mapped to the TDF.

Results
The search retrieved 490 original articles. Eight papers met the review criteria. Key issues centred around strategies for managing challenges experienced during consultations, managing patient concerns, peer support and wider public awareness of AMR. The two most common TDF domains highlighted as influences on prescribing behaviour, represented in all studies were; social influences and beliefs about consequences.

Conclusions
The core domains highlighted as influential to appropriate antibiotic prescribing should be considered when developing future interventions. Focus should be given to overcoming social influences (patients, other clinicians) and reassurance in relation to beliefs about negative consequences (missing something that could lead to a negative outcome).
Original languageEnglish
Article numberdkaa335
Number of pages13
JournalJournal of Antimicrobial Chemotherapy
DOIs
Publication statusPublished - 7 Aug 2020

Keywords

  • antibiotics
  • consultation
  • nurses
  • pharmacists
  • respiratory tract infections
  • tenofovir
  • prescribing behavior

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