Active Monitoring" Versus "Wait and See": Tackling Action Bias in Antibiotic Prescribing Through Strategic Decision Framing.

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This collaborative research project, grounded in psychology, aims to conduct the first comprehensive investigation of action bias in the context of antibiotic prescribing and to develop new framing of treatment options to mitigate against it. The project will draw on mixed methods such as qualitative interviews and quantitative experiments. Additionally, it will include engagement with Antimicrobial Stewardship at Leicester Royal Infirmary that will ensure engagement with clinical stakeholders. The project aims to address the following research questions: 1. How do hospital prescribers perceive and evaluate active versus non-active approaches to managing suspected infections? 2. What active terminology can be used to re-frame decisions that are typically perceived to be non-active (e.g. choices to delay antibiotic prescribing)? 3. How effective is a re-framing of non-active language for changing behaviour and reducing antibiotic overprescribing?The project will be divided into comprehensive literature review on psychological theory and application its application in healthcare and beyond. Followed by qualitative research into clinical attitudes towards antibiotic prescription and knowledge of antimicrobial resistance. With knowledge drawn from the findings, multiple versions of accessible material will be developed in collaboration with Leicester Royal Infirmary Antimicrobial Stewardship. These will be trialled with clinicians from several trusts using mixed design approach to identify the most effective approach.