Near-patient tests and the clinical gaze in decision-making of Swedish GPs not following current guidelines for sore throat - A qualitative interview study

BMC Family Practice

Volumn 16, Issue 1, 2015, Pages

  Gröndal, Hedvig ^a   Hedin, Katarina ^b,c   Strandberg, Eva Lena ^b,d   André, Malin ^a,e   Brorsson, Annika ^b,f  

^a UPPSALA UNIVERSITY   (Sweden)

^b LUND UNIVERSITY   (Sweden)

^c Department of Research and Development ^*  (Sweden)

^d Blekinge County Council   (Sweden)

^e LINKÖPING UNIVERSITY   (Sweden)

^f Center for Primary Health Care Research   (Sweden)

Author keywords

Decision making; Guidelines; Near patient tests; Qualitative interview study; Sore throat

Indexed keywords

ANTIINFECTIVE AGENT;

CLINICAL PRACTICE; DISEASE MANAGEMENT; FEMALE; GENERAL PRACTITIONER; HEALTH PERSONNEL ATTITUDE; HUMAN; IMMUNOLOGICAL PROCEDURES; IMMUNOLOGY; INAPPROPRIATE PRESCRIBING; ISOLATION AND PURIFICATION; MALE; MICROBIOLOGY; MIDDLE AGED; PHARYNGITIS; POINT OF CARE TESTING; PRACTICE GUIDELINE; PREVENTION AND CONTROL; PROCEDURES; PROTOCOL COMPLIANCE; PSYCHOLOGY; QUALITATIVE RESEARCH; STANDARDS; STATISTICS AND NUMERICAL DATA; STREPTOCOCCUS PYOGENES; SWEDEN; SYMPTOM ASSESSMENT;

ANTI-BACTERIAL AGENTS; ATTITUDE OF HEALTH PERSONNEL; DISEASE MANAGEMENT; FEMALE; GENERAL PRACTITIONERS; GUIDELINE ADHERENCE; HUMANS; IMMUNOLOGIC TESTS; INAPPROPRIATE PRESCRIBING; MALE; MIDDLE AGED; PHARYNGITIS; POINT-OF-CARE TESTING; PRACTICE GUIDELINES AS TOPIC; PRACTICE PATTERNS, PHYSICIANS'; QUALITATIVE RESEARCH; STREPTOCOCCUS PYOGENES; SWEDEN; SYMPTOM ASSESSMENT;

EID: 84936083135     PISSN: None     EISSN: 14712296     Source Type: Journal    
DOI: 10.1186/s12875-015-0285-y     Document Type: Article

References (23)

1. Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ. 2010;340:c2096.
2. Bradley CP. Taking another look at the acute sore throat. Br J Gen Pract. 2000;50(459):780-1.
3. Stanton N, Francis NA, Butler CC. Reducing uncertainty in managing respiratory tract infections in primary care. Br J Gen Pract. 2010;60(581):e466-75.
4. Chiappini E, Regoli M, Bonsignori F, Sollai S, Parretti A, Galli L, et al. Analysis of different recommendations from international guidelines for the management of acute pharyngitis in adults and children. Clin Ther. 2011;33(1):48-58.
5. Aalbers J, O'Brien KK, Chan WS, Falk GA, Teljeur C, Dimitrov BD, et al. Predicting streptococcal pharyngitis in adults in primary care: a systematic review of the diagnostic accuracy of symptoms and signs and validation of the Centor score. BMC Med. 2011;9:67.
6. Medical Product Agency. Management of pharyngotonsillitis - recommendations [Handla¨ggning av faryngotonsilliter]. Information från la¨kemedelsverket. 2001;12:44-70.
7. Madurell J, Balague M, Gomez M, Cots JM, Llor C. Impact of rapid antigen detection testing on antibiotic prescription in acute pharyngitis in adults. FARINGOCAT STUDY: a multicentric randomized controlled trial. BMC Fam Pract. 2010;11:25.
8. Llor C, Madurell J, Balague-Corbella M, Gomez M, Cots JM. Impact on antibiotic prescription of rapid antigen detection testing in acute pharyngitis in adults: a randomised clinical trial. Br J Gen Pract. 2011;61(586):244-51.
9. Linder JA, Chan JC, Bates DW. Evaluation and treatment of pharyngitis in primary care practice: the difference between guidelines is largely academic. Arch Intern Med. 2006;166(13):1374-9.
10. Neumark T, Brudin L, Molstad S. Use of rapid diagnostic tests and choice of antibiotics in respiratory tract infections in primary healthcare-a 6-y follow-up study. Scand J Infect Dis. 2010;42(2):90-6.
11. Hedin K, Brorsson A, Mölstad S, Strandberg EL. Antibiotics and near-patient testing: Differences in habits between physicians completing or discontinuing a medical audit. Health. 2014;6(2):141-48.
12. Gulich MS, Matschiner A, Gluck R, Zeitler HP. Improving diagnostic accuracy of bacterial pharyngitis by near patient measurement of C-reactive protein (CRP). Br J Gen Pract. 1999;49(439):119-21.
13. Andre M, Schwan A, Odenholt I. The use of CRP tests in patients with respiratory tract infections in primary care in Sweden can be questioned. Scand J Infect Dis. 2004;36(3):192-7.
14. Tonkin-Crine S, Yardley L, Little P. Antibiotic prescribing for acute respiratory tract infections in primary care: a systematic review and meta-ethnography. J Antimicrob Chemother. 2011;66(10):2215-23.
15. Berg M, Mol A, Appadurai A, editors. Differences in Medicine. Unraveling Practices, Techniques, and Bodies. London: Duke University Press; 1998
16. Hedin K, Strandberg EL, Gröndal H, Brorsson A, Thulesius H, André M. Management of patients with sore throat in relation to guidelines - an interview study. Scand J Prim Health Care. 2014. (in press)
17. Malterud K. Qualitative research: standards, challenges, and guidelines. Lancet. 2001;358(9280):483-8.
18. Leydon GM, McDermott L, Moore M, Williamson I, Hobbs FDR, Lambton T, et al. A qualitative study of GP, NP and patient views about the use of rapid streptococcal antigen detection tests (RADTs) in primary care: 'swamped with sore throats?'. BMJ Open. 2013;3(4):e002460.
19. Foucault M. The Birth of the Clinic. London: Tavistock; 1973.
20. Burke P, Bain J, Lowes A, Athersuch R. Rational decisions in managing sore throat: evaluation of a rapid test. Br Med J (Clin Res Ed). 1988;296(6637):1646-9.
21. Hjortdahl P, Landaas S, Urdal P, Steinbakk M, Fuglerud P, Nygaard B. C-reactive protein: a new rapid assay for managing infectious disease in primary health care. Scand J Prim Health Care. 1991;9(1):3-10.
22. Mol A. The Body Multiple: Ontology in Medical Practice. Durham, N.C: Duke University Press; 2002.
23. Timmermans S, Berg M. Standardization in Action: Achieving Local Universality through Medical Protocols. Soc Stud Sci. 1997;27:273-306.