Department of Applied Pharmacy, Faculty of Pharmacy, Riga Stradiņš University, Riga, Latvia.
Department of Anthropology, Faculty of Humanities, University of Latvia, Riga, Latvia.
BMC Prim Care. 2022 Nov 4;23(1):275. doi: 10.1186/s12875-022-01881-x.
Tonsillopharyngitis is one of the most frequently observed upper respiratory tract infections, for which antibiotics are prescribed in ambulatory care. In most cases, tonsillopharyngitis is benign and self-limiting, mostly a viral condition. The aim of this study was to explore the diagnostic and treatment process of tonsillopharyngitis by general practitioners and to understand decisions regarding antibiotic prescribing and the factors that shape these practices.
METHODS/DESIGN: This was a qualitative interview study in primary care practices in Latvia. Semi-structured face-to-face interviews were conducted with general practitioners from November 2016 to January 2017. Thematic analysis was applied to identify factors that influence the prescribing practice in a primary care setting in conjunction with a specific context in which the prescriber practices.
Decisions and practice of general practitioner are not static over time or context; they occur within an environmental setting influenced by individual factors of general practitioners, the health care system, and practice-specific factors that shape the diagnosis and antibiotic prescribing in the tonsillopharyngitis. Interviewed general practitioners rely primarily on their personal experience, perception, and skills acquired in their practice, which are encouraged by the environment, where the necessary tools and resources are not in place to encourage rational prescribing of antibiotics.
General practitioners' decision regarding antibiotic prescribing is an unstable concept that differs between prescribers. The health care system could augment the experience of general practitioners through structural changes such as guidelines, availability of antibiotics, and available antibiotics package size.
扁桃体咽炎是最常见的上呼吸道感染之一，在门诊治疗中会开抗生素。在大多数情况下，扁桃体咽炎是良性和自限性的，主要是病毒性疾病。本研究旨在通过全科医生探索扁桃体咽炎的诊断和治疗过程，并了解有关抗生素处方的决策以及影响这些实践的因素。
方法/设计：这是在拉脱维亚初级保健实践中进行的一项定性访谈研究。2016 年 11 月至 2017 年 1 月期间，对全科医生进行了半结构化的面对面访谈。采用主题分析来确定影响初级保健环境中处方实践的因素，同时结合从业者实践的特定背景来确定这些因素。
全科医生的决策和实践不是静态的，不会随着时间或环境的变化而变化；它们发生在一个受个体因素、医疗保健系统和特定实践因素影响的环境中，这些因素塑造了扁桃体咽炎的诊断和抗生素处方。接受采访的全科医生主要依赖于他们在实践中获得的个人经验、感知和技能，这些技能受到环境的鼓励，而环境中没有提供必要的工具和资源来鼓励合理使用抗生素。
全科医生开抗生素的决定是一个不稳定的概念，不同的医生之间存在差异。医疗保健系统可以通过结构变革来增强全科医生的经验，例如指南、抗生素的可用性和可用抗生素的包装大小。
