Survey of Spanish general practitioners’ attitudes toward management of sore throat: an internet-based questionnaire study

Abstract

BackgroundThe management of sore throat varies widely in Europe. The objective of this study was to gain insight into clinicians’ perceptions on the current management of sore throat in Spain.MethodsCross-sectional, internet-based questionnaire study answered from July to September 2013. General practitioners (GPs) affiliated with the two largest scientific societies of primary care were invited to participate in the study. Questions were asked about physician knowledge, the use of current national guidelines for sore throat management, and management in two clinical scenarios, depicting a young adult with sore throat and: 1. cough, coriza with or without fever, and 2. fever without cough and coriza.ResultsThe questionnaire was completed by 1476 GPs (5%) and 12.7% declared using rapid antigen detection tests. Antibiotics were considered by 18.8% of the GPs in the first scenario and by 32% in the second scenario (p < 0.001). The antibiotics most commonly mentioned by GPs were amoxicillin and amoxicillin + clavulanate (52.7 and 31.2%, respectively) whereas penicillin V was only prescribed in 11.9% of the cases. The drugs most commonly considered in both scenarios were analgesics and anti-inflammatory drugs. Antitussives, decongestants and expectorants were more commonly prescribed in cases of suspected viral infection (p < 0.001).ConclusionsGPs have misconceptions as to the indications for using rapid antigen detection tests and prescribing drugs in the management of sore throat. These results suggest that guidelines are seldom followed since one in five GPs declared giving antibiotics for patients with a suspected viral infection and the use of second-choice antibiotics seems considerable.

Examining the Effect of Context, Beliefs, and Values on UK Farm Veterinarians’ Antimicrobial Prescribing: A Randomized Experimental Vignette and Cross-Sectional Survey

“…Vignette studies are not without their limitations, but they do enable researchers to explore potentially influential factors in situations where a field-based experiment may be challenging to conduct [ 42 , 43 ]. In human medicine, vignettes have been widely used, and within the context of AMR have been specifically used to investigate antimicrobial prescribing decisions by GPs and hospital doctors across a range of conditions [ 44 , 45 , 46 ]. The use of vignettes within veterinary medicine is relatively limited however, although one recent vignette study identified a number of non-clinical factors that were associated with likelihood of prescribing antibiotics by farm vets, including habit, farmer relationship, and prescribing practices of other vets [ 10 ].…”

Exploring the social ecology for appropriate antibiotic prescribing and stewardship in primary care: presenting the VALUE driven model of practice derived from qualitative analysis of public and private care settings in Singapore

“…In addition, antibiotic prescribing by a primary care doctor has been found to be dependent on the doctor's presentation of 'expert self', 'benevolent self' and 'practical self' during the clinical consultation, and in uenced by interaction with the patient and the context of clinical practice [7]. However, existing literature has mainly focused on direct in uencers impacting the doctor's antibiotic prescribing decisions such as the lack of resources to guide clinical judgment, pressure due to diagnostic uncertainties and busy consultations, and patient demands and expectations, while the contributory role of the broader clinical practice environment on prescribing behaviours has been largely under-explored [8][9][10][11][12][13][14][15][16][17].…”

“…In addition, there is a paucity of qualitative studies in countries where the doctor both prescribes and dispenses medications in the clinic [8][9][10][11][12][13][14][15][16][17][20][21][22][23][24][25]. The current study contributes to this body of literature and aims at exploring transferable ndings pertaining to the social ecology in uencing antibiotic prescribing.…”

Veinticinco mitos en enfermedades infecciosas en atención primaria que se asocian con sobrediagnóstico y sobretratamiento

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