General practitioners' views on the acceptability and applicability of a web-based intervention to reduce antibiotic prescribing for acute cough in multiple European countries: a qualitative study prior to a randomised trial.
General practitioners' views on the acceptability and applicability of a web-based intervention to reduce antibiotic prescribing for acute cough in multiple European countries: a qualitative study prior to a randomised trial.
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全科医生对基于Web的干预措施的可接受性和适用性减少抗生素处方急性咳嗽的观点：在随机试验前进行定性研究。
DOI：
10.1186/1471-2296-13-101
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发表时间：
2012-10-11
影响因子：
2.9
通讯作者：
GRACE INTRO study team
中科院分区：
文献类型：
--
作者：
Anthierens S;Tonkin-Crine S;Douglas E;Fernandez-Vandellos P;Krawczyk J;Llor C;Cals JW;Francis NA;Yardley L;Coenen S;Verheij T;Goossens H;Little P;GRACE INTRO study team
促进全科医生谨慎开出抗生素处方的干预措施通常只为在一个国家使用而开发。我们的目标是开发一种适合在多个欧洲国家实施的干预措施，以便在使用较少资源的同时为实践提供更大的好处。INTRO(抗生素使用互联网培训)干预需要向全科医生提供培训，如何在患者附近使用C-反应蛋白(CRP)测试来帮助诊断急性咳嗽，并提高沟通技能，以帮助向患者解释处方决定。我们探讨了全科医生对INTRO初始版本的看法，以测试可接受性，并在随机试验开始之前潜在地增加在多个国家使用的适用性。来自五个国家(比利时、英国、荷兰、波兰和西班牙)的30名全科医生接受了“大声思考”的采访。全科医生被要求在干预过程中进行工作，并在自己的实践中讨论他们对干预的内容和形式的看法。GPS查看了相同的干预，但版本是以五种语言创建的。使用主题分析对数据进行编码。所有五个国家的全科医生报告认为，干预解决了一个重要的主题，广泛接受和可行的使用，将是一个有用的工具，以帮助改善临床实践。然而，不同国家的全科医生确定了干预的一些方面，这些方面没有反映他们的民族文化或医疗保健系统。这包括在咨询中使用的沟通方式的感知差异，咨询时间和患者通常出现的疾病阶段。支持循证使用抗生素的在线干预在多个国家的全科医生中实施是可以接受和可行的。然而，有必要通过增加当地信息并更加强调全科医生可以选择他们希望在实践中使用的沟通技能这一事实，来调整干预措施以适应各国的情况。使用大声思考的方法来补充干预措施的发展，是确定干预措施实施的区域背景障碍的有力方法。
Interventions to promote prudent antibiotic prescribing by general practitioners (GPs) have often only been developed for use in one country. We aimed to develop an intervention which would be appropriate to implement in multiple European countries in order to offer greater benefit to practice whilst using fewer resources. The INTRO (INternet TRaining for antibiOtic use) intervention needed to deliver training to GPs in the use of C-Reactive Protein (CRP) near patient tests to help diagnose acute cough and in communication skills to help explain prescribing decisions to patients. We explored GPs’ views on the initial version of INTRO to test acceptability and potentially increase applicability for use in multiple countries before the start of a randomised trial. 30 GPs from five countries (Belgium, England, the Netherlands, Poland and Spain), were interviewed using a “think aloud” approach. GPs were asked to work through the intervention and discuss their views on the content and format in relation to following the intervention in their own practice. GPs viewed the same intervention but versions were created in five languages. Data were coded using thematic analysis. GPs in all five countries reported the view that the intervention addressed an important topic, was broadly acceptable and feasible to use, and would be a useful tool to help improve clinical practice. However, GPs in the different countries identified aspects of the intervention that did not reflect their national culture or healthcare system. These included perceived differences in communication style used in the consultation, consultation length and the stage of illness at which patient typically presented. An online intervention to support evidence-based use of antibiotics is acceptable and feasible to implement amongst GPs in multiple countries. However, tailoring of the intervention to suit national contexts was necessary by adding local information and placing more emphasis on the fact that GPs could select the communication skills they wished to use in practice. Using think aloud methods to complement the development of interventions is a powerful method to identify regional contextual barriers to intervention implementation.
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影响因子：
--
作者：
Campbell, M;Fitzpatrick, R;Tyrer, P
通讯作者：
Tyrer, P
影响因子：
2.1
作者：
Godycki-Cwirko, Maciek;Nocun, Marek;Melbye, Hasse
通讯作者：
Melbye, Hasse
影响因子：
2.4
作者：
Gosden, T;Forland, F;Pedersen, L
通讯作者：
Pedersen, L
影响因子：
4.4
作者：
Jansen, Yvonne J. F. M.;Foets, Marleen M. E.;de Bont, Antoinette A.
通讯作者：
de Bont, Antoinette A.
影响因子：
105.7
作者：
Francis, Nick A.;Butler, Christopher C.;Nuttall, Jacqueline
通讯作者：
Nuttall, Jacqueline