Infectious disease management in primary care: perceptions of GPs

Abstract

BackgroundIt is important to keep the level of antibiotic prescribing low to contain the development of resistant bacteria. This study was conducted to reveal new knowledge about how GPs think in relation to the prescribing of antibiotics - knowledge that could be used in efforts toward rational treatment of infectious diseases in primary care. The aim was to explore and describe the variations in GPs' perceptions of infectious disease management, with special reference to antibiotic prescribing.MethodsTwenty GPs working at primary care centres in a county in south-west Sweden were purposively selected based on the strategy of including GPs with different kinds of experience. The GPs were interviewed and perceptions among GPs were analysed by a phenomenographic approach.ResultsFive qualitatively different perceptions of infectious disease management were identified. They were: (A) the GP must help the patient to achieve health and well-being; (B) the management must meet the GP's perceived personal, professional and organisational demands; (C) restrictive antibiotic prescribing is time-consuming; (D) restrictive antibiotic prescribing can protect the effectiveness of antibiotics; and (E) patients benefit personally from restrictive antibiotic prescribing.ConclusionsRestrictive antibiotic prescribing was considered important in two perceptions, was not an issue as such in two others, and was considered in one perception although the actual prescribing was greatly influenced by the interaction between patient and GP. Accordingly, to encourage restrictive antibiotic prescribing several aspects must be addressed. Furthermore, different GPs need various kinds of support. Infectious disease management in primary care is complex and time-consuming, which must be acknowledged in healthcare organisation and planning.

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Why do general practitioners prescribe antibiotics for upper respiratory tract infections to meet patient expectations: a mixed methods study

“…Several studies have indicated that other issues like previous experience, uncertainty about diagnosis, ease of follow-up and fear of consequences of non-prescribing, as well as perceptions of potential conflict with patients and perceived pressure to prescribe, and consequences for the future doctor–patient relationship are more of a concern for GPs prescribing antibiotics than antibiotic resistance21–25 Similar views regarding concerns about the consequences of not prescribing antibiotics and resistance being primarily a societal issue have been reported by GPs in other qualitative studies 1819 26…”

Awareness of antibiotic resistance and antibiotic prescribing in UTI treatment: A qualitative study among primary care physicians in Sweden

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“…The issue of antibiotic resistance may also be thought of as a national problem that does not concern the physician's own practice [33], a concept that was also seen among participants in our study. When the physicians considered antibiotic resistance as an important factor, they did follow recommended regimens more often, according to their own reports [28,29]. …”