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dc.contributor.authorPhillips, Rhiannon
dc.contributor.authorStanton, H.
dc.contributor.authorSingh-Mehta, A.
dc.contributor.authorGillespie, David
dc.contributor.authorBates, Janine
dc.contributor.authorGal, Micaela
dc.contributor.authorThomas-Jones, Emma
dc.contributor.authorLowe, Rachel
dc.contributor.authorHood, Kerenza
dc.contributor.authorLlor, Carl
dc.contributor.authorMelbye, Hasse
dc.contributor.authorCals, Jochen
dc.contributor.authorWhite, Patrick
dc.contributor.authorButler, Christopher C.
dc.contributor.authorFrancis, Nick
dc.date.accessioned2021-04-13T09:22:02Z
dc.date.available2021-04-13T09:22:02Z
dc.date.issued2020-06-25
dc.description.abstractBackground - Antibiotics are prescribed to >70% of patients presenting in primary care with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The PACE randomised controlled trial found that a C-reactive protein point-of-care test (CRP-POCT) management strategy for AECOPD in primary care resulted in a 20% reduction in patient-reported antibiotic consumption over 4 weeks.<p> <p>Aim - To understand perceptions of the value of CRP-POCT for guiding antibiotic prescribing for AECOPD; explore possible mechanisms, mediators, and pathways to effects; and identify potential barriers and facilitators to implementation from the perspectives of patients and clinicians.<p> <p>Design and setting - Qualitative process evaluation in UK general practices.<p> <p>Method - Semi-structured telephone interviews with 20 patients presenting with an AECOPD and 20 primary care staff, purposively sampled from the PACE study. Interviews were audio-recorded, transcribed, and analysed using framework analysis.<p> <p>Results - Patients and clinicians felt that CRP-POCT was useful in guiding clinicians’ antibiotic prescribing decisions for AECOPD, and were positive about introduction of the test in routine care. The CRP-POCT enhanced clinician confidence in antibiotic prescribing decisions, reduced decisional ambiguity, and facilitated communication with patients. Some clinicians thought the CRP-POCT should be routinely used in consultations for AECOPD; others favoured use only when there was decisional uncertainty. CRP-POCT cartridge preparation time and cost were potential barriers to implementation.<p> <p>Conclusion - CRP-POCT-guided antibiotic prescribing for AECOPD had high acceptability, but commissioning arrangements and further simplification of the CRP-POCT need attention to facilitate implementation in routine practice.en_US
dc.identifier.citationPhillips, Stanton, Singh-Mehta, Gillespie, Bates, Gal, Thomas-Jones, Lowe, Hood, Llor, Melbye, Cals, White, Butler, Francis. C-reactive protein-guided antibiotic prescribing for COPD exacerbations: A qualitative evaluation. British Journal of General Practice. 2020;70(696):E505-E513en_US
dc.identifier.cristinIDFRIDAID 1889956
dc.identifier.doi10.3399/bjgp20X709865
dc.identifier.issn0960-1643
dc.identifier.issn1478-5242
dc.identifier.urihttps://hdl.handle.net/10037/20860
dc.language.isoengen_US
dc.publisherRoyal College of General Practitionersen_US
dc.relation.journalBritish Journal of General Practice
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2020 The Author(s)en_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801en_US
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801en_US
dc.titleC-reactive protein-guided antibiotic prescribing for COPD exacerbations: A qualitative evaluationen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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