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Home self-administration of intravenous antibiotics as part of an outpatient parenteral antibiotic therapy service: a qualitative study of the perspectives of patients who do not self-administer.

Tonna, Antonella; Anthony, Geraldine; Tonna, Ivan; Paudyal, Vibhu; Forbes-McKay, Katrina; Laing, Rob; Mackenzie, Alexander; Falconer, Sharon; McCartney, Gillian; Stewart, Derek

Authors

Geraldine Anthony

Ivan Tonna

Vibhu Paudyal

Katrina Forbes-McKay

Rob Laing

Alexander Mackenzie

Sharon Falconer

Gillian McCartney

Derek Stewart



Abstract

Objectives: This study aimed to use a theoretical approach to understand the determinants of behaviour in patients not home self-administering intravenous antibiotics. Setting: Outpatient care: included patients were attending an outpatient clinic for intravenous antibiotic administration in the northeast of Scotland. Participants: Patients were included if they had received more than 7 days of intravenous antibiotics and were aged 16 years and over. Twenty potential participants were approached, and all agreed to be interviewed. 13 were male with a mean age of 54 years (SD +17.6). Outcomes: Key behavioural determinants that influenced patients’ behaviours relating to self-administration of intravenous antibiotics. Design: Qualitative, semistructured in-depth interviews were undertaken with a purposive sample of patients. An interview schedule, underpinned by the Theoretical Domains Framework (TDF), was developed, reviewed for credibility and piloted. Interviews were audio-recorded and transcribed verbatim. Data were analysed thematically using the TDF as the coding framework. Results: The key behavioural determinants emerging as encouraging patients to self-administer intravenous antibiotics were the perceptions of being sufficiently knowledgeable, skilful and competent and that self-administration afforded the potential to work while administering treatment. The key determinants that impacted their decision not to self-administer were lack of knowledge of available options, a perception that hospital staff are better trained and anxieties of potential complications. Conclusion: Though patients are appreciative of the skills and knowledge of hospital staff, there is also a willingness among patients to home self-administer antibiotics. However, the main barrier emerges to be a perceived lack of knowledge of ways of doing this at home. To overcome this, a number of interventions are suggested based on evidence-based behavioural change techniques.

Citation

TONNA, A., ANTHONY, G., TONNA, I., PAUDYAL, V., FORBES-MCKAY, K., LAING, R., MACKENZIE, A., FALCONER, S., MCCARTNEY, G. and STEWART, D. 2019. Home self-administration of intravenous antibiotics as part of an outpatient parenteral antibiotic therapy service: a qualitative study of the perspectives of patients who do not self-administer. BMJ open [online], 9(1), article ID e027475. Available from: https://doi.org/10.1136/bmjopen-2018-027475

Journal Article Type Article
Acceptance Date Dec 7, 2018
Online Publication Date Jan 25, 2019
Publication Date Jan 31, 2019
Deposit Date Feb 11, 2019
Publicly Available Date Feb 11, 2019
Journal BMJ open
Print ISSN 2044-6055
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 9
Issue 1
Article Number e027475
DOI https://doi.org/10.1136/bmjopen-2018-027475
Keywords Self-administering; Intravenous antibiotics; NE Scotland; Key behavioural determinants
Public URL http://hdl.handle.net/10059/3285

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