Microbiology; Immunology and Allergy; Immunology; Microbiology (medical); Infectious Diseases
Abstract :
[en] [en] BACKGROUND: The ARON study, a randomized controlled trial, assesses a behavioural intervention incorporating clinically guided C-reactive protein (CRP) point-of-care testing and a parental information booklet to reduce inappropriate antibiotic prescriptions for acutely ill children in Belgian primary care.
OBJECTIVES: To explore GP and parent views and experiences regarding the ARON trial intervention.
METHODS: We conducted a qualitative embedded process evaluation in Belgian general practice. Semi-structured interviews were held with purposively sampled GPs and a convenience sample of mothers of acutely ill children presenting to primary care. Data were analysed using inductive thematic analysis.
RESULTS: Thirty-four interviews were conducted with 17 GPs and 17 parents from the intervention arm, and four themes were identified. The first theme centres on the supportive role of CRP point-of-care testing in reducing diagnostic uncertainty and decreasing inappropriate prescriptions. The second theme explores the use of CRP in managing perceived parental expectations of antibiotics. The third theme discusses the use of intermediate CRP levels (above the trial's 5 mg/L cut-off) as an indicator of serious infection, as opposed to its intended role in the trial as a rule-out factor. The final theme delves into the dual functionality of the booklet, enhancing self-management and offering reassurance through safety-netting advice. A logic model depicts the assumptions and (un)anticipated dynamics underlying the relationships between these themes and their subthemes.
CONCLUSION: Both GPs and parents consider the intervention to be a helpful complementary tool during consultations for acutely ill children.
Disciplines :
Public health, health care sciences & services
Author, co-author :
D'hulster, Erinn ; Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium ; Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
This work was supported by the Belgian Health Care Knowledge Centre, as part of their KCE Trials programme, funding the ARON trial KCE18-1137 including this qualitative study.This manuscript has been conducted as part of Erinn D\u2019hulster\u2019s PhD training (joint degree at KU Leuven and University of Antwerp), which is supported by funding provided for the ARON trial.
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