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      Recent migrants’ perspectives on antibiotic use and prescribing in primary care: a qualitative study

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          Abstract

          Background

          Currently there is great interest in antibiotic prescribing practices in the UK, but little is known about the experiences of the increasing numbers of recent migrants (those present in the UK for >1 year but <5 years) registered at GP practices. Qualitative research has suggested that reasons for not prescribing antibiotics may not be clearly communicated to migrants.

          Aim

          This study aimed to explore the factors that shape migrants’ experiences of and attitudes to antibiotics, and to suggest ways to improve effective communication around their use.

          Design and setting

          A qualitative study on recent migrants’ health beliefs, values, and experiences in a community setting in primary care.

          Method

          Twenty-three recent migrants were interviewed in their preferred language by trained community researchers. The research team conducted a thematic analysis, focusing on health beliefs, engaging with health services, transnational medicine, and concepts of fairness. Experiences around antibiotics were a strong emerging theme.

          Results

          Three reasons were identified for antibiotics seeking: first, holding an ‘infectious model’ of illness implying that antibiotics are required quickly to avoid illness becoming worse or spreading to others; second, reasoning that other medications will be less effective for people ‘used to’ antibiotics’; and third, perceiving antibiotic prescription as a sign of being taken seriously. Some participants obtained antibiotics from their country of origin or migrant networks in the UK; others changed their mind and accepted alternatives.

          Conclusion

          Primary care professionals should aim to understand migrants’ perspectives to improve communication with patients. Further research is needed to identify different strategies needed to respond to the varying understandings of antibiotics held by migrants.

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          Most cited references33

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          Using thematic analysis in psychology

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            Super-diversity and its implications

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              Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem.

              Antimicrobial resistance is a global public health challenge, which has accelerated by the overuse of antibiotics worldwide. Increased antimicrobial resistance is the cause of severe infections, complications, longer hospital stays and increased mortality. Overprescribing of antibiotics is associated with an increased risk of adverse effects, more frequent re-attendance and increased medicalization of self-limiting conditions. Antibiotic overprescribing is a particular problem in primary care, where viruses cause most infections. About 90% of all antibiotic prescriptions are issued by general practitioners, and respiratory tract infections are the leading reason for prescribing. Multifaceted interventions to reduce overuse of antibiotics have been found to be effective and better than single initiatives. Interventions should encompass the enforcement of the policy of prohibiting the over-the-counter sale of antibiotics, the use of antimicrobial stewardship programmes, the active participation of clinicians in audits, the utilization of valid rapid point-of-care tests, the promotion of delayed antibiotic prescribing strategies, the enhancement of communication skills with patients with the aid of information brochures and the performance of more pragmatic studies in primary care with outcomes that are of clinicians' interest, such as complications and clinical outcomes.
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                Author and article information

                Contributors
                Role: Lecturer in qualitative methods
                Role: Senior research fellow in ethnography
                Role: Lecturer in the anthropology of health care
                Role: Research associate
                Role: Director
                Journal
                Br J Gen Pract
                Br J Gen Pract
                bjgp
                The British Journal of General Practice
                Royal College of General Practitioners
                0960-1643
                1478-5242
                November 2016
                31 August 2016
                31 August 2016
                : 66
                : 652
                : e802-e809
                Affiliations
                Institute for Applied Health Research;
                School of Social and Community Medicine, University of Bristol, Bristol.
                Health Services Management Centre;
                Institute for Applied Health Research;
                Institute of Research into Superdiversity, University of Birmingham, Birmingham.
                Author notes
                Address for correspondence Antje Lindenmeyer, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. E-mail: a.lindenmeyer@ 123456bham.ac.uk
                Article
                10.3399/bjgp16X686809
                5072918
                27578814
                83df24a5-b132-41e1-a249-b157c619e49d
                © British Journal of General Practice 2016

                This is an OpenAccess article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 February 2016
                : 09 March 2016
                : 11 May 2016
                Categories
                Research

                antibacterial agents,migrants and transients,prescriptions,primary health care,qualitative research

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