Evidence map›Paper›PMID 40887116›Full record

ArticleBMJ open2025

Enablers and barriers to antimicrobial stewardship for upper respiratory tract infections in Kosovo's primary care: a qualitative study protocol.

Erza Selmani, Lul Raka, Shaip Krasniqi, Arianit Jakupi, Nandini Sreenivasan, Ahmad Wesal Zaman, Riaz Agahi, Lumi Lila, Robert Leo Skov, Ilir Hoxha

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Review
  2. Article
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

10 authors.

Erza SelmaniEvidence Synthesis Group, Prishtina, Kosovo.
Lul RakaFaculty of Medicine, University of Prishtina, Prishtina, Kosovo.
Shaip KrasniqiFaculty of Medicine, University of Prishtina, Prishtina, Kosovo.
Arianit JakupiUniversity of Business and Technology, Prishtina, Kosovo.
Nandini SreenivasanInternational Centre for Antimicrobial Resistance Solutions (ICARS), Copenhagen, Denmark.
Ahmad Wesal ZamanInternational Centre for Antimicrobial Resistance Solutions (ICARS), Copenhagen, Denmark.
Riaz AgahiEvidence Synthesis Group, Prishtina, Kosovo.ORCID http://orcid.org/0000-0001-5497-7886
Lumi LilaEvidence Synthesis Group, Prishtina, Kosovo.
Robert Leo SkovInternational Centre for Antimicrobial Resistance Solutions (ICARS), Copenhagen, Denmark.
Ilir HoxhaEvidence Synthesis Group, Prishtina, Kosovo ilir@evidencesynthesis.group.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionUpper respiratory tract infections (URTIs) are one of the most common reasons for primary care visits, yet often do not require treatment with antibiotics. Antibiotic use is associated with side effects and the development of antibiotic resistance. Antimicrobial stewardship (AMS) programmes are essential to mitigate this issue. Many countries, including Kosovo, an upper-middle-income country, have not yet implemented AMS programmes. The implementation of AMS in Kosovo is shaped by economic, social, technological and legal factors. However, it is the structural weaknesses within the health system that pose the most significant barriers. This study will examine the barriers and enablers for AMS programmes for URTIs in the primary care setting. METHODS AND ANALYSIS: We plan to employ a qualitative case study approach, comprising interviews and focus groups conducted at six primary care sites within Kosovo, as well as central health institutions. We will include diverse stakeholders involved or affected by AMS implementation, such as healthcare workers, patients and their representatives, and policymakers from the Ministry of Health. The Consolidated Framework for Implementation Research will guide the design of the study, data collection and analysis. We will use framework analysis to examine key themes within the domains of intervention characteristics, outer setting, inner setting, characteristics of individuals involved, the implementation process and other insights. ETHICS AND DISSEMINATION: Ethical approval was obtained from the Kosovo Doctors Chamber (Reference No 122/2024), and we will adhere to good practice in terms of informed consent and data protection. Findings will be disseminated primarily through peer-reviewed publications.

Indexed as

Anti-Bacterial AgentsAntimicrobial StewardshipPrimary Health CareRespiratory Tract InfectionsFocus GroupsHumansKosovoQualitative ResearchResearch DesignAnti-Bacterial AgentsAntibioticsPrimary CareQUALITATIVE RESEARCH

Identifiers

PMID40887116
PMCPMC12406928

What OpenQuestion holds

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Registered trials

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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.