ArticleBMJ open2020
Primary care physicians' attitudes and perceptions towards antibiotic resistance and outpatient antibiotic stewardship in the USA: a qualitative study.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04799886 (Attitudes Associated to Prescription of ADHD Drugs Among Child and Adolescent Psychiatrists in Region Skåne.), which is not on this map. Cited by 38 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Attitudes Associated to Prescription of ADHD Drugs Among Child and Adolescent Psychiatrists in Region Skåne.
Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Factors contributing to the variation in antibiotic prescribing among primary health care physicians: a systematic review.BMC primary care · 2024Pooled it
- Physicians', pharmacists', and nurses' education of patients about antibiotic use and antimicrobial resistance in primary care settings: a qualitative systematic literature review.Frontiers in antibiotics · 2024Pooled it
- Self-reported acceptability and feasibility of a multimodal intervention to reduce antibiotic prescriptions for urinary tract infections in primary care: a process evaluation of the RedAres trial among general practitioners and medical practice assistants.BMC health services research · 2025Trial
- A Discrete Choice Experiment of Clinician Preferences Among Attributes of Approved Janus Kinase Inhibitors for Alopecia Areata.Advances in therapy · 2026Article
- Advancing Antimicrobial Stewardship in Canadian Dentistry: Early Insights Into a Toolkit to De-implement Overprescribing.International dental journal · 2026Article
- Optimizing antimicrobial stewardship in urology: a qualitative study on needs, values and requirements for clinical decision support.Infection prevention in practice · 2026Article
- Barriers and enablers to using evidence-based antibiotic prescription guidelines in primary care: a qualitative systematic review and synthesis using the theoretical domains framework.Implementation science communications · 2026Review
- Article
- Physician Antibiotic Prescribing Preferences in Community Acquired Pneumonia and Complicated Urinary Tract Infections: A National Discrete Choice Experiment.Open forum infectious diseases · 2026Article
- Mixed-method evaluation of interactive provider dashboards for comparison of outpatient antibiotic prescribing for respiratory and otic conditions in walk-in clinics.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Community pharmacists and outpatient antimicrobial stewardship: evidence, uncertainties, and future directions.Frontiers in health services · 2026Article
- The influence of social relationships on clinician interpretation of performance data in an outpatient antibiotic stewardship intervention.Antimicrobial resistance and infection control · 2025Article
- Specialty and age-based differences in awareness and attitudes towards antibiotic stewardship: a cross-sectional online survey on Japanese clinic physicians.BMC infectious diseases · 2025Article
- Increasing the use of the WHO AWaRe system in antibiotic surveillance and stewardship programmes in low- and middle-income countries.JAC-antimicrobial resistance · 2025Review
- National Survey of Factors Associated with Physician Antibiotic Prescribing Preferences.Journal of general internal medicine · 2025Article
- Doctors' perceptions of antimicrobial resistance in the Northern West Bank, Palestine: a qualitative study.JAC-antimicrobial resistance · 2025Article
- Top publications for advancing state and local health department antimicrobial stewardship programs.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Prescribing antibiotics prudently-A survey of policy implementation drivers among physicians and veterinarians.One health (Amsterdam, Netherlands) · 2024Article
- Antibiotic Prescribing Patterns for Respiratory Tract Illnesses Following the Conclusion of an Education and Feedback Intervention in Primary Care.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Evaluation of an automated feedback intervention to improve antibiotic prescribing among primary care physicians (OPEN Stewardship): a multinational controlled interrupted time-series study.Microbiology spectrum · 2024Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectivesAt least 30% of outpatient antibiotic prescriptions are unnecessary. Outpatient antibiotic stewardship is needed to improve prescribing and address the threat of antibiotic resistance. A better understanding of primary care physicians (PCPs) attitudes towards antibiotic prescribing and outpatient antibiotic stewardship is needed to identify barriers to stewardship implementation and help tailor stewardship strategies. The aim of this study was to assess PCPs current attitudes towards antibiotic resistance, inappropriate antibiotic prescribing and the feasibility of outpatient stewardship efforts.
designEight focus groups with PCPs were conducted by an independent moderator using a moderator guide. Focus groups were audio recorded, transcribed and coded for major themes using deductive and inductive content analysis methods.
settingFocus groups were conducted in four US cities: Philadelphia, Birmingham, Chicago and Los Angeles.
participantsTwo focus groups were conducted in each city-one with family medicine and internal medicine physicians and one with paediatricians. A total of 26 family medicine/internal medicine physicians and 26 paediatricians participated.
resultsParticipants acknowledged that resistance is an important public health issue, but not as important as other pressing problems (eg, obesity, opioids). Many considered resistance to be more of a hospital issue. While participants recognised inappropriate prescribing as a problem in outpatient settings, many felt that the key drivers were non-primary care settings (eg, urgent care clinics, retail clinics) and patient demand. Participants reacted positively to stewardship efforts aimed at educating patients and clinicians. They questioned the validity of antibiotic prescribing metrics. This scepticism was due to a number of factors, including the feasibility of capturing prescribing quality, a belief that physicians will 'game the system' to improve their measures, and dissatisfaction and distrust of quality measurement in general.
conclusionsStakeholders will need to consider physician attitudes and beliefs about antibiotic stewardship when implementing interventions aimed at improving prescribing.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.