Autonomy, power dynamics and antibiotic use in primary healthcare: A qualitative study

Autor: Ana Moragas, Laura Medina-Perucha, Ramon Monfà, Josep Maria Cots, Carl Llor, Anna Berenguera, Alicia Borras, Anna Lanau-Roig, Isabel Amo, Pablo Gálvez-Hernández, Ana García-Sangenís
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Health Care Providers
Geographical locations
0302 clinical medicine
Antibiotics
Health care
Medicine and Health Sciences
Global health
Medical Personnel
030212 general & internal medicine
Respiratory Tract Infections
Qualitative Research
media_common
Allied Health Care Professionals
0303 health sciences
Multidisciplinary
Antimicrobials
Drugs
Drug Resistance
Microbial
Patient Preference
Middle Aged
Primary care
Anti-Bacterial Agents
Europe
Professions
Atenció primària
Medicine
Female
Health education
Thematic analysis
Psychology
Autonomy
Research Article
Adult
Risk
Science
media_common.quotation_subject
Medical Services
Microbiology
Vulnerable Populations
Nonprobability sampling
03 medical and health sciences
Nursing
Microbial Control
Physicians
Humans
European Union
Aged
Resistència als medicaments
Pharmacology
Primary Health Care
030306 microbiology
business.industry
Biology and Life Sciences
Communication in Health Care
Health Care
Spain
Antibiotic Resistance
Drug resistance
People and Places
Personal Autonomy
Population Groupings
Private healthcare
Antimicrobial Resistance
Power
Psychological
business
Qualitative research
Zdroj: Dipòsit Digital de la UB
Universidad de Barcelona
PLoS ONE
PLoS ONE, Vol 15, Iss 12, p e0244432 (2020)
Popis: Antibiotic resistance is a global health concern. Although numerous strategies have tried to reduce inadequate antibiotic prescribing, antibiotics are still prescribed in 60% of acute lower respiratory tract infections (ALRTIs) cases in Catalonia (Spain). This study aims to explore service users’ experiences of ALRTIs, the quality and access to healthcare services, and health education. Selective purposive sampling was carried out, based on a prior definition of participant characteristics. These were sex, age, ethnicity, date of the last ALRTI, number of ALRTIs in the last year, and treatments received. Participants with a previous diagnosis of ALRTIs were recruited from three primary health care centres in Barcelona and one in Tarragona. Twenty-nine interviews were conducted between April and June 2019. A content thematic analysis was performed. Three themes were identified: 1) risk perceptions and help-seeking; 2) treatment preferences and antibiotic use; and 3) relationship dynamics and communication with healthcare professionals. Accounts of service users’ sense of autonomy towards their health and power dynamics within the healthcare system were apparent. Supporting service users to become reliable, subjective and agentic experts of their health and bodies could help them to voice their healthcare agendas. Power structures embedded within healthcare, political and economic institutions should be challenged so that healthcare services can be co-developed (with service users) and based on service users’ autonomy and horizontal relationships. Special consideration should be paid to the intersection of social vulnerabilities. A concordance approach to prescribing could be key to improve the responsible use of antibiotics and to contribute to the prevention of AMR in primary healthcare. The marketisation of health, and the increased demands of private healthcare in Spain due to the financial pressures on public healthcare as a consequence of the financial crisis of 2008 and the COVID-19 pandemic, are a risk for promoting adequate antibiotic prescribing and use. Trial registration The ISAAC-CAT study has been registered in the NCT registry, ID: NCT03931577.
Databáze: OpenAIRE
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