The latent factors of antibiotic prescribing
| No. | Factor characteristics | Survey questions included in the factor loading | Factor scores, mean (SD) | α | |
|---|---|---|---|---|---|
| High prescribing | Low prescribing | ||||
| 1 | Medical knowledge and clinical competency | Q1) Symptoms of AURI cannot be relieved faster by antibiotics | −0.36 (0.06) | 0.41 (0.06) | 0.74 |
| Q2) I am less comfortable giving antibiotics to patients with AURI than giving them | |||||
| Q3) I think antibiotics are overprescribed in primary care | |||||
| Q4 I do not find it difficult to determine whether antibiotics are needed for my patients with AURI | |||||
| Q5) I do not prescribe antibiotics if I don’t think the patient needs them because I am not worried that I will miss a bacterial infection | |||||
| Q6) I do not prescribe antibiotics if I don’t think the patient needs them because the risk of giving antibiotics is not low (for example, an allergic reaction) | |||||
| Q7) I do not prescribe antibiotics if I don’t think the patient needs them because I am not worried about the risk of bacterial complications from a viral AURI | |||||
| 2 | Conservative practice (giving antibiotics ‘to be on the safe side’) | Q8) I am more likely to give antibiotics to patients with AURI if they are at the extremes of age (that is, in paediatric or geriatric age groups) | 0.12 (0.06) | −0.13 (0.08) | 0.66 |
| Q9) I am more likely to give antibiotics if the patient has comorbidities (for example, diabetes mellitus, COPD, chronic renal disease) | |||||
| Q10) I am more likely to give antibiotics if the patient returns for a repeat visit for the same respiratory condition | |||||
| Q11) I am more likely to give antibiotics if the patient has >3 days of respiratory symptoms | |||||
| 3 | GPs’ perceived patient expectations | Q12) If I do not prescribe antibiotics to my patients with AURI, they will usually ask for them | −0.06 (0.07) | 0.07 (0.07) | 0.61 |
| Q13) I prescribe antibiotics even if I don’t think the patient needs them because I think the patient expects them | |||||
| Q14) I prescribe antibiotics even if I don’t think the patient needs them because otherwise the patient will then seek medical attention elsewhere | |||||
| 4 | Good clinical practice | Q15) If I don’t think my patient needs antibiotics, I will not prescribe them | −0.31(0.07) | 0.35 (0.07) | 0.64 |
| Q16) If a patient who does not need antibiotics asks for them, I will explain to them why I think they do not need them | |||||
| Q17) I am able to convince my patients who do not need antibiotics that they will not benefit from them | |||||
| Q18) I think I prescribe antibiotics appropriately | |||||
| 5 | Availability of diagnostic tests | Q19) To diagnose pneumonia, in addition to physical examination I routinely do further investigations (for example, FBC, CXR) | −0.15 (0.06) | 0.17 (0.08) | 0.62 |
| Q20) If I am uncertain whether an AURI is of viral or bacterial origin, I depend on diagnostic tests (for example, FBC, CRP, throat culture). | |||||
| Q21 The turnaround time for diagnostic tests for AURI infections is not too long to be useful in my practice | |||||
| 6 | Desire to improve clinical practice | Q22) I hope the Ministry of Health will publish a clinical practice guideline on use of antibiotics in AURI | −0.16 (0.07) | 0.18 (0.07) | 0.73 |
| Q23) A national guideline would change my antibiotic prescribing pattern | |||||
| Q24) I would be keen to take part in an education programme aimed at reducing antibiotic prescription in primary care | |||||
AURI = acute upper respiratory tract infections. COPD = chronic obstructive pulmonary disease. CRP = C-reactive protein. CXR = chest X-ray. FBC = full blood count.