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Antibiotic prescribing in UK out-of-hours primary care services: a realist-informed scoping review of training and guidelines for health care professionals

Alves, PG; Hayward, G; Leydon, G; Barnes, R; Woods, C; Webb, J; Booker, M; ... Stevenson, F; + view all (2021) Antibiotic prescribing in UK out-of-hours primary care services: a realist-informed scoping review of training and guidelines for health care professionals. BJGP Open 10.3399/BJGPO.2020.0167. Green open access

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Abstract

BACKGROUND: Antibiotic overuse has contributed to antimicrobial resistance, a global public health problem. In the UK, despite the fall in rates of antibiotic prescription since 2013, prescribing levels remain high in comparison with other European countries. Prescribing in out of hours care (OOH) provides unique challenges for prudent prescribing, for which professionals may not be prepared. AIM: To explore the guidance available to professionals on prescribing antibiotics for common infections in OOH primary care within the UK, with a focus on training resources, guidelines, and clinical recommendations. DESIGN AND METHOD: We carried out a realist-informed scoping review of peer-reviewed papers and grey literature focusing on antibiotic prescribing OOH (eg, clinical guidelines, training videos). General prescribing guidance was searched whenever OOH-focused resources were unavailable. Electronic databases and websites of national agencies and professional societies were searched following PRISMA standards. Findings were organised according to realist review components ie, mechanisms, contexts, and outcomes. RESULTS: 46 clinical guidelines and eight training resources were identified. Clinical guidelines targeted adults and children and included recommendations on prescription strategy, spectrum of the antibiotic prescribed, communication with patients, treatment duration, and decision-making processes. CONCLUSION: No clinical guidelines or training resources focusing specifically on OOH were found. Our results highlight a lack of knowledge about whether existing resources address the challenges faced by OOH antibiotic prescribers. Further research is needed to explore the training needs of OOH health professionals, and whether further OOH-focused resources need to be developed given the rates of antibiotic prescribing in this setting.

Type: Article
Title: Antibiotic prescribing in UK out-of-hours primary care services: a realist-informed scoping review of training and guidelines for health care professionals
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.3399/BJGPO.2020.0167
Publisher version: https://doi.org/10.3399/BJGPO.2020.0167
Language: English
Additional information: Copyright © 2021, The Authors. This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/).
Keywords: Community care, Guidelines, Prescribing
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10125301
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