A study of antibiotic prescribing: the experience of Lithuanian and Russian GPs

Jaruševičienė, Lina; Radzevičienė-Jurgutė, Rūta; Lazarus, Jeffrey V.; Jurgutis, Arnoldas; Ovhed, Ingvar; Strandberg, Eva-Lena; Bjerrum, Lars

doi:10.2478/s11536-012-0062-4

Cited by 10 publications

(16 citation statements)

References 40 publications

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“…The findings of this study indicate that a common policy in a primary care centre is a success factor in the task of improving prescribing habits. Corresponding results have been found in previous research as well as in a focus-group study on similar topics among Happy Audit participants in Lithuania and the Kaliningrad region [26,27]. …”

Section: Discussionsupporting

confidence: 88%

“I'm Dr JekyllandMr Hyde”: Are GPs’ antibiotic prescribing patterns contextually dependent? A qualitative focus group study

Strandberg

Brorsson

Hagstam³

et al. 2013

Scandinavian Journal of Primary Health Care

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ObjectiveTo explore factors and circumstances contributing to prudent antibiotic prescribing for respiratory tract infections in primary care.DesignTwo focus groups representing rural and urban areas. A semi-structured interview guide with open-ended questions and an editing analysis style was used. They were examined to identify meaning units that were sorted into categories in an iterative process throughout the analysis.SettingPrimary health care in two counties in southern Sweden.SubjectsTwo groups including seven and six general practitioners (GPs) respectively, men and women of different ages with different professional experiences.Main outcome measuresExploration of categories, determination of themes, construction of models.ResultsThe decision to prescribe antibiotics takes place in the encounter between GP and patient, initially characterized by harmony or fight and the subsequent process by collaboration or negotiation, resulting in agreement, compromise, or disagreement. Several factors influence the meeting and contribute to enhancing the conditions for rational prescribing. These conditions are connected to the GP, the relationship, and the setting; organization as well as professional culture. The findings indicate synergies between the factors, and that one factor can sometimes compensate for lack of another. Continuity and mutual trust can make a brief consultation successful, but lack of continuity can eliminate the effects of knowledge and professional skills.ConclusionsThe findings emphasize the importance of the encounter between the GP and the patient for prudent antibiotic prescribing. Furthermore, the importance of an appropriate organization of primary care, which promotes continuity and encourages professional autonomy, is demonstrated.

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Section: Discussionsupporting

confidence: 88%

“I'm Dr JekyllandMr Hyde”: Are GPs’ antibiotic prescribing patterns contextually dependent? A qualitative focus group study

Strandberg

Brorsson

Hagstam³

et al. 2013

Scandinavian Journal of Primary Health Care

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“…This high level of patient trust in ABs has likewise been reported in other countries, and a study conducted in Russia and Lithuania found that prescribing ABs for URTI has become an integral and even common practice for these types of infections [6]. …”

Section: Discussionmentioning

confidence: 69%

Antibiotic knowledge, attitudes and behaviours of Albanian health care professionals and patients – a qualitative interview study

Kaae

Malaj

Hoxha

2017

J of Pharm Policy and Pract

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BackgroundThe inappropriate use of antimicrobials is a problem worldwide. To target future interventions, a thorough understanding of the reasons behind this current behaviour is needed. Within the EU, the culture of antimicrobial use has been intensely studied, but this is not the case in non-EU southeastern European countries, despite the frequent use of (broad-spectrum) antibiotics (ABs) in this region. The aim of this study was to explore AB knowledge, attitudes and behaviours of health care professionals (HCPs) and patients in one southeastern European country, Albania.MethodsIn total, 16 semi-structured interviews were carried out with four groups of interviewees: physicians, community pharmacists, and patients with and without AB prescriptions. Interviews were used to investigate participants’ recent practices with four specific antibiotics for upper respiratory tract infections, along with their typical behaviours, knowledge and attitudes towards the use of antimicrobials. A directed content analysis was applied.ResultsThe patients showed little awareness of the differences between viruses and bacteria; however, they often self-diagnosed, which led them to request ABs from pharmacies without a prescription. Pharmacists felt pressured to give in to patients’ demands. All of the participants (including HCP) showed suboptimal beliefs about illness severity as they all believed that ‘flu complications’, i.e. flu/cold symptoms that persisted after 2–3 days, should be treated with ABs. Physicians usually had no rapid tests to guide them in their practice; however, they were not concerned about this fact. HCPs acknowledged AMR, but only a few of them seemed to consider its risk in their daily practice.ConclusionsPatients had high levels of trust in and desire for ABs, and HCPs did not often negotiate with patients’ demands. Suggested initiatives to improve the prudent use of ABs in Albania include higher reimbursement for prescribed antibiotics (to reduce illegal sales), academic detailing as well as implementing public awareness campaigns.Electronic supplementary materialThe online version of this article (doi:10.1186/s40545-017-0102-1) contains supplementary material, which is available to authorized users.

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“…Revealed non-pharmacological factors for antibiotic prescriptions that affect physician–patient communication about antibiotic prescription have been discussed elsewhere (37). …”

Section: Methodsmentioning

confidence: 99%

Enabling factors for antibiotic prescribing for upper respiratory tract infections: Perspectives of Lithuanian and Russian general practitioners

Jaruševičienė

Jurgute

Bjerrum

et al. 2013

Upsala Journal of Medical Sciences

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Introduction General practitioners (GPs) write about 80% of all antibiotic prescriptions, the greatest number of them for patients with respiratory tract infections. However, there is a lack of research targeting the influence of external factors on antibiotic prescribing by physicians. This study aimed to explore experiences of GPs in Lithuania and the Russian Federation with regard to antibiotic prescription for upper respiratory tract infections. By such means it might be possible to reveal external enabling factors that influence antibiotic prescribing in these countries.Method Five focus groups were performed with 22 GPs from Lithuania and 29 GPs from the Kaliningrad Region of the Russian Federation; then, thematic analysis of data was performed.Results Six thematic categories were identified that are related to external forces enabling antibiotic prescription: the necessity for political leadership to encourage clinically grounded antibiotic use; over-the-counter sale of antibiotics; designation of antibiotics as reimbursable medications; supervision by external oversight institutions; lack of guidelines for the treatment of upper respiratory tract infections; and pharmaceutical company activities.Conclusions Comprehensive efforts to reduce the burden of non-clinically grounded antibiotic prescription should go beyond addressing factors at the physician–patient level and take into account important factors in the enabling environment as well.

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A study of antibiotic prescribing: the experience of Lithuanian and Russian GPs

Cited by 10 publications

References 40 publications

“I'm Dr JekyllandMr Hyde”: Are GPs’ antibiotic prescribing patterns contextually dependent? A qualitative focus group study

“I'm Dr JekyllandMr Hyde”: Are GPs’ antibiotic prescribing patterns contextually dependent? A qualitative focus group study

Antibiotic knowledge, attitudes and behaviours of Albanian health care professionals and patients – a qualitative interview study

Enabling factors for antibiotic prescribing for upper respiratory tract infections: Perspectives of Lithuanian and Russian general practitioners

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