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

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
• 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