Using a child’s antibiotic history as a data-enabled brief intervention to optimise antibiotic prescribing

Problem

One in four GP appointments are for children. Many of these appointments are for “respiratory tract infections” (RTIs). At least 1 in 3 children are prescribed an unnecessary course of antibiotics for these illnesses. Recent research from over 250,000 UK children highlighted those children who had taken two or more antibiotic courses for RTIs in the last year had around a 30% greater chance of not responding to treatment for future RTIs compared to children who had not taken no antibiotics.

Approach

Our primary aim was to explore the feasibility of using a child’s antibiotic history as a data-enabled brief intervention to optimise antibiotic prescribing. This research has two phases. In phase 1, through a series of ‘think aloud’ workshops and interviews, we worked together with parents and clinicians on how best to design the computer screen prompt and personalised consultation print-out and whether this would be acceptable for parents and clinicians. In phase 2, GPs/nurses have the opportunity to explore and use a prototype computer-based prompt and consultation flyer/print-out, developed from Phase 1 and integrated into the GP computer software (EMIS) and share their feedback through a series of ‘think aloud’ interviews to refine the intervention.

Findings

We have iteratively co-developed two components of an electronically embedded intervention (computer-screen prompt, patient-facing flyer/print-out) with parents of young children, clinicians and information design specialists. Phase 2 is currently in progress.

Consequences

We will produce an automated computer screen prompt that is acceptable and feasible to use during GP consultations and is ready to be tested in a future trial. If shown to be effective, such automated electronic tools could be scaled up in GP practices to promote better antibiotic prescribing for children.