Evidence map›Paper›PMID 33004384›Full record

ArticleBMJ open2020

Developing a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice and subsequently change antibiotic use.

Marta Santillo, Marta Wanat, Mina Davoudianfar, Emily Bongard, Sinisa Savic, Louise Savic, Catherine Porter, Joanne Fielding, Christopher C Butler, Sue Pavitt and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 1 country.

Marta SantilloNuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK marta.santillo@phc.ox.ac.uk.ORCID 0000-0001-6345-7612
Marta WanatNuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK.
Mina DavoudianfarNuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK.
Emily BongardNuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK.ORCID 0000-0001-5957-6280
Sinisa SavicFaculty of Medicine and Health, University of Leeds, Leeds, Leeds, UK.ORCID 0000-0001-7910-0554
Louise SavicFaculty of Medicine and Health, University of Leeds, Leeds, Leeds, UK.
Catherine PorterHealthcare Associated Infection Group, University of Leeds, Leeds, West Yorkshire, UK.
Joanne FieldingHealthcare Associated Infection Group, University of Leeds, Leeds, West Yorkshire, UK.
Christopher C ButlerNuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK.
Sue PavittUniversity of Leeds, Leeds, UK.
Jonathan SandoeHealthcare Associated Infection Group, University of Leeds, Leeds, West Yorkshire, UK.
Sarah Tonkin-CrineNuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK.ORCID 0000-0003-4470-1151
AlABAMA team
University of Leeds · GBUniversity of Oxford · GB

Funding

Department of Health RP-PG-1214-20007
6 · The paper itself

Abstract

objectivesTo develop a behavioural intervention package to support clinicians and patients to amend incorrect penicillin allergy records in general practice. The intervention aimed to: (1) support clinicians to refer patients for penicillin allergy testing (PAT), (2) support patients to attend for PAT and (3) support clinicians and patients to prescribe or consume penicillin, when indicated, following a negative PAT result.

methodsTheory-based, evidence-based and person-based approaches were used in the intervention development. We used evidence from a rapid review, two qualitative studies, and expert consultations with the clinical research team to identify the intervention 'guiding principles' and develop an intervention plan. Barriers and facilitators to the target behaviours were mapped to behaviour change theory in order to describe the proposed mechanisms of change. In the final stage, think-aloud interviews were conducted to optimise intervention materials.

resultsThe collated evidence showed that the key barriers to referral of patients by clinicians were limited experience of referral and limited knowledge of referral criteria and PAT. Barriers for patients attending PAT were lack of knowledge of the benefits of testing and lack of motivation to get tested. The key barriers to the prescription and consumption of first-line penicillin following a negative test result were patient and clinician beliefs about the accuracy of PAT and whether taking penicillin was safe. Intervention materials were designed and developed to address these barriers.

conclusionsWe present a novel behavioural intervention package designed to address the multiple barriers to uptake of PAT in general practice by clinicians and patients. The intervention development details how behaviour change techniques have been incorporated to hypothesise how the intervention is likely to work to help amend incorrect penicillin allergy records. The intervention will go on to be tested in a feasibility trial and randomised controlled trial in England.

Indexed as

Anti-Bacterial AgentsGeneral PracticeEnglandHumansPenicillinsUnited KingdomAnti-Bacterial AgentsPenicillinsallergygeneral medicine (see internal medicine)infectious diseases

Identifiers

PMID33004384
PMCPMC7534681
OpenAlexW3089371369

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.