Exploring factors associated with antimicrobial prescribing in adults with acute respiratory infection (ARI) amongst UK secondary care prescribers and the potential utility of host response testing to improve use: a questionnaire-based survey
Acute respiratory infection, antibiotic prescribing
This study aims to explore factors associated with antibiotic prescribing by secondary care prescribers in adult patients with acute respiratory illness (ARI), in whom viruses are detected. Also, to investigate the potential of novel host response test results to influence prescribing. This will be achieved through a mixed-methods model. To help inform the design of the cross-sectional questionnaire, focus group interviews will be conducted with key stake holder groups (Medical Consultants, Registrars, Resident Doctors and prescribing Nurse Practitioners and Advanced Care Practitioners) at UHS who work in Acute medicine, Emergency medicine, Infectious diseases, Elderly care, General medicine and Respiratory medicine, to understand what factors they consider important when making antibiotics prescribing decisions in a patient with ARI who have a viral pathogen detected. The study will also determine which characteristics of new host response tests they would consider most important in assisting with these decisions. The focus groups, of a maximum size of four, will be led by one of the study team, and participants will be invited through a group email sent through the trust's HR department. Purposive sampling will be performed by screening basic demographic data (seniority, ethnicity and speciality) of those who express interest. The focus group will be performed, and audio recorded virtually on MS Teams. Within the transcript, participants' identities will be kept confidential, but their seniority, ethnicity and medical speciality will be noted. Analysis will take place using reflective thematic analysis, and will include: reading and familiarisation of the transcripts, noting and recording initial themes and then conducting systematic and detailed open coding using ethnographic research software. Focus group data collection will stop once the information power has been reached. After thematic analysis from the focus groups, a detailed literature search will inform
Qualified prescribing Medical Doctor, Nurse practitioner or Advanced Care Practitioner, working within secondary care in the NHS, whose primary patients are ≥18 years of age 1. Participants must regularly assess patients presenting to the hospital with ARI 2. Participants must work in the following specialities: Emergency medicine, Acute medicine, Respiratory medicine, Geriatric medicine, Infectious diseases, General medicine
Not meeting the inclusion criteria