Please use this identifier to cite or link to this item: https://doi.org/10.3399/bjgp17X688885
Title: Medical and psychosocial factors associated with antibiotic prescribing in primary care: survey questionnaire and factor analysis
Authors: Lee, Tau-Hong
Wong, Joshua GX
Lye, David CB
Chen I-Cheng Mark 
LOH WENG KEONG VICTOR 
LEO YEE SIN 
Lee, Linda K
CHOW LI PING ANGELA 
Keywords: Science & Technology
Life Sciences & Biomedicine
Primary Health Care
Medicine, General & Internal
General & Internal Medicine
acute upper respiratory infections
antibiotics
knowledge
attitudes and practices
factors
primary care
RESPIRATORY-TRACT INFECTIONS
DOCTOR-PATIENT-RELATIONSHIP
ANTIMICROBIAL RESISTANCE
STREPTOCOCCUS-PNEUMONIAE
ACUTE COUGH
ATTITUDES
PHYSICIANS
PRESCRIPTIONS
GPS
EXPECTATIONS
Issue Date: 1-Mar-2017
Publisher: ROYAL COLL GENERAL PRACTITIONERS
Citation: Lee, Tau-Hong, Wong, Joshua GX, Lye, David CB, Chen I-Cheng Mark, LOH WENG KEONG VICTOR, LEO YEE SIN, Lee, Linda K, CHOW LI PING ANGELA (2017-03-01). Medical and psychosocial factors associated with antibiotic prescribing in primary care: survey questionnaire and factor analysis. BRITISH JOURNAL OF GENERAL PRACTICE 67 (656) : E168-E177. ScholarBank@NUS Repository. https://doi.org/10.3399/bjgp17X688885
Abstract: © 2017 British Journal of General Practice. Background Acute upper respiratory infections (AURI) are the leading causes of antibiotic prescribing in primary care although antibiotics are often not indicated. Aim To gain an understanding of the knowledge, attitudes, and practices (KAP) of GPs in Singapore and the associated latent factors to guide the implementation of an effective programme to reduce antibiotic use in primary care. Design and setting An anonymous survey on the KAP of antibiotic use in AURI of GPs in Singapore. Method KAP survey questionnaires were posted to all GPs from a database. To ascertain the latent factors affecting prescribing patterns, exploratory factor analysis was performed. Results Among 427 responses, 351 (82.2%) were from GPs working in private practice. It was found that 58.4% of GPs in the private versus 72.4% of those in the public sector recognised that <80% of AURIs were caused by viruses (P = 0.02). The majority of GPs (353/427; 82.7%) felt that antibiotics were overprescribed in primary care. Significant factors associated with low antibiotic prescribing were good medical knowledge and clinical competency (adjusted odds ratio [aOR] 3.2, 95% confidence interval [CI] = 2.4 to 4.3), good clinical practice (aOR 2.7 [95% CI = 2.0 to 3.6]), availability of diagnostic tests (aOR 1.4 [95% CI = 1.1 to 1.8]), and desire to improve clinical practice (aOR 1.5 [95% CI = 1.2 to 1.9]). The conservative practice of giving antibiotics 'to be on the safe side' is significantly less likely to be associated with low antibiotic prescribing (aOR 0.7 [95% CI = 0.5 to 0.9]). Conclusion This is the first KAP survey on antibiotic prescribing for AURI among GPs in Singapore. With the latent factors identified, future interventions should be directed at addressing these factors to reduce inappropriate antibiotic prescribing.
Source Title: BRITISH JOURNAL OF GENERAL PRACTICE
URI: https://scholarbank.nus.edu.sg/handle/10635/162772
ISSN: 0960-1643
1478-5242
DOI: 10.3399/bjgp17X688885
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