ArticleBritish journal of clinical pharmacology2016
The determinants of antimicrobial prescribing among hospital doctors in England: a framework to inform tailored stewardship interventions.
Article in British journal of clinical pharmacology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Machine says go, doctor says no: an ecological momentary assessment analysis examining clinicians' perceptions of, and their antibiotic prescribing behaviour when using rapid molecular diagnostic tests in intensive care.Antimicrobial resistance and infection control · 2026Trial
- Understanding antibiotic prescribing in the inpatient setting: a synthesis of evidence on determinants and interventions.Antimicrobial resistance and infection control · 2026Article
- Strategies to improve antimicrobial stewardship in surgery: insights from an ethnographic study.BMJ open · 2026Article
- Complex Hospital-Based Electronic Prescribing-Based Intervention to Support Antimicrobial Stewardship: Qualitative Study.JMIR formative research · 2024Article
- Quality, availability and suitability of antimicrobial stewardship guidance: a multinational qualitative study.JAC-antimicrobial resistance · 2024Article
- Behavioral Components and Context of Antimicrobial Prescription in a Tertiary Hospital in Portugal.Antibiotics (Basel, Switzerland) · 2023Article
- ePrescribing-Based Antimicrobial Stewardship Practices in an English National Health Service Hospital: Qualitative Interview Study Among Medical Prescribers and Pharmacists.JMIR formative research · 2023Article
- Vancomycin prescribing and therapeutic drug monitoring: Challenges of real clinical practice.PloS one · 2023Article
- Implementation of antimicrobial stewardship programmes in private healthcare settings in Africa: A scoping review.Health SA = SA Gesondheid · 2023Article
- Coping with 'the grey area' of antibiotic prescribing: a theory-informed qualitative study exploring family physician perspectives on antibiotic prescribing.BMC primary care · 2022Article
- Understanding surgical antimicrobial prescribing behaviour in the hospital setting: a systematic review and meta-ethnography protocol.Systematic reviews · 2020Article
- General practitioners' accounts of negotiating antibiotic prescribing decisions with patients: a qualitative study on what influences antibiotic prescribing in low, medium and high prescribing practices.BMC family practice · 2019Article
- Patients' and Clinicians' Perceptions of Antibiotic Prescribing for Upper Respiratory Infections in the Acute Care Setting.Medical decision making : an international journal of the Society for Medical Decision Making · 2018Article
- Antimicrobial Stewardship in Veterinary Medicine.Microbiology spectrum · 2018Review
- Categorical Risk Perception Drives Variability in Antibiotic Prescribing in the Emergency Department: A Mixed Methods Observational Study.Journal of general internal medicine · 2017Observational
- Behavioral Approach to Appropriate Antimicrobial Prescribing in Hospitals: The Dutch Unique Method for Antimicrobial Stewardship (DUMAS) Participatory Intervention Study.JAMA internal medicine · 2017Article
- Knowledge of antibiotic resistance and antibiotic prescription practices among prescribers in the Brong Ahafo Region of Ghana; a cross-sectional study.BMC health services research · 2017Article
- The determinants of antimicrobial prescribing among hospital doctors in England: a framework to inform tailored stewardship interventions.British journal of clinical pharmacology · 2016Article
- Surgical Antimicrobial Prophylaxis and Adherence to Standard Treatment Guidelines: Urgent Need of Antimicrobial Stewardship Program.Journal of research in pharmacy practiceArticle
- Antimicrobial stewardship programs; a two-part narrative review of step-wise design and issues of controversy Part I: step-wise design of an antimicrobial stewardship program.Therapeutic advances in infectious diseaseReview
Corrections and comments
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Authors and funding
2 authors.
Funding
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Abstract
aimLittle is known about the determinants of antimicrobial prescribing behaviour (APB), how they vary between hospital prescribers or the mechanism by which interventions are effective. Yet, interventions based on a sound theoretical understanding of APB are more likely to be successful in changing outcomes. This study sought to quantify the potential determinants of APB among hospital doctors in south-west England.
methodsThis multicentre, quantitative study employed a closed answer questionnaire to garner hospital doctors' views on factors influencing their APB. Underlying constructs within the data were identified using exploratory factor analysis and subsequent pairwise comparisons assessed for variance between groups of prescribers.
resultsThe questionnaire was completed by 301 doctors across four centres (response rate ≥ 74%) and three key factors were identified: autonomy, guidelines adherence and antibiotic awareness. The internal consistency for the questionnaire scale and for each factor subscale was good (α ≥ 0.7). Subgroup analysis identified significant differences between groups of prescribers: autonomy scores increased with grade until at the specialist trainee level (P ≤ 0.009), foundation doctors scored higher for guidelines adherence than consultants (P = 0.004) and specialist trainees (P = 0.003) and United Kingdom trained doctors scored higher than those trained abroad for antibiotic awareness (P < 0.0005). Scores did not vary significantly between doctors from different centres.
conclusionAutonomy, guidelines adherence and antibiotic awareness were identified as important factors relevant to APB, which vary with experience and training. A theoretical framework is offered to facilitate development of more effective, tailored interventions to change APBs.
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