Context and general practitioner decision-making - a scoping review of contextual influence on antibiotic prescribing

Abstract Background How contextual factors may influence GP decisions in real life practice is poorly understood. The authors have undertaken a scoping review of antibiotic prescribing in primary care, with a focus on the interaction between context and GP decision-making, and what it means for the...

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Autores principales:	Resha Al-Azzawi, Peder A. Halvorsen, Torsten Risør
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Decision-making Context Contextual factors Contextual influence Non-medical factors General practice Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/6c8bc5b1063347999d884f4dc2bf297f
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spelling	oai:doaj.org-article:6c8bc5b1063347999d884f4dc2bf297f2021-11-21T12:32:33ZContext and general practitioner decision-making - a scoping review of contextual influence on antibiotic prescribing10.1186/s12875-021-01574-x1471-2296https://doaj.org/article/6c8bc5b1063347999d884f4dc2bf297f2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12875-021-01574-xhttps://doaj.org/toc/1471-2296Abstract Background How contextual factors may influence GP decisions in real life practice is poorly understood. The authors have undertaken a scoping review of antibiotic prescribing in primary care, with a focus on the interaction between context and GP decision-making, and what it means for the decisions made. Method The authors searched Medline, Embase and Cinahl databases for English language articles published between 1946 and 2019, focusing on general practitioner prescribing of antibiotics. Articles discussing decision-making, reasoning, judgement, or uncertainty in relation to antibiotic prescribing were assessed. As no universal definition of context has been agreed, any papers discussing terms synonymous with context were reviewed. Terms encountered included contextual factors, non-medical factors, and non-clinical factors. Results Three hundred seventy-seven full text articles were assessed for eligibility, resulting in the inclusion of 47. This article documented the experiences of general practitioners from over 18 countries, collected in 47 papers, over the course of 3 decades. Contextual factors fell under 7 themes that emerged in the process of analysis. These were space and place, time, stress and emotion, patient characteristics, therapeutic relationship, negotiating decisions and practice style, managing uncertainty, and clinical experience. Contextual presence was in every part of the consultation process, was vital to management, and often resulted in prescribing. Conclusion Context is essential in real life decision-making, and yet it does not feature in current representations of clinical decision-making. With an incomplete picture of how doctors make decisions in real life practice, we risk missing important opportunities to improve decision-making, such as antibiotic prescribing.Resha Al-AzzawiPeder A. HalvorsenTorsten RisørBMCarticleDecision-makingContextContextual factorsContextual influenceNon-medical factorsGeneral practiceMedicine (General)R5-920ENBMC Family Practice, Vol 22, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Decision-making Context Contextual factors Contextual influence Non-medical factors General practice Medicine (General) R5-920
spellingShingle	Decision-making Context Contextual factors Contextual influence Non-medical factors General practice Medicine (General) R5-920 Resha Al-Azzawi Peder A. Halvorsen Torsten Risør Context and general practitioner decision-making - a scoping review of contextual influence on antibiotic prescribing
description	Abstract Background How contextual factors may influence GP decisions in real life practice is poorly understood. The authors have undertaken a scoping review of antibiotic prescribing in primary care, with a focus on the interaction between context and GP decision-making, and what it means for the decisions made. Method The authors searched Medline, Embase and Cinahl databases for English language articles published between 1946 and 2019, focusing on general practitioner prescribing of antibiotics. Articles discussing decision-making, reasoning, judgement, or uncertainty in relation to antibiotic prescribing were assessed. As no universal definition of context has been agreed, any papers discussing terms synonymous with context were reviewed. Terms encountered included contextual factors, non-medical factors, and non-clinical factors. Results Three hundred seventy-seven full text articles were assessed for eligibility, resulting in the inclusion of 47. This article documented the experiences of general practitioners from over 18 countries, collected in 47 papers, over the course of 3 decades. Contextual factors fell under 7 themes that emerged in the process of analysis. These were space and place, time, stress and emotion, patient characteristics, therapeutic relationship, negotiating decisions and practice style, managing uncertainty, and clinical experience. Contextual presence was in every part of the consultation process, was vital to management, and often resulted in prescribing. Conclusion Context is essential in real life decision-making, and yet it does not feature in current representations of clinical decision-making. With an incomplete picture of how doctors make decisions in real life practice, we risk missing important opportunities to improve decision-making, such as antibiotic prescribing.
format	article
author	Resha Al-Azzawi Peder A. Halvorsen Torsten Risør
author_facet	Resha Al-Azzawi Peder A. Halvorsen Torsten Risør
author_sort	Resha Al-Azzawi
title	Context and general practitioner decision-making - a scoping review of contextual influence on antibiotic prescribing
title_short	Context and general practitioner decision-making - a scoping review of contextual influence on antibiotic prescribing
title_full	Context and general practitioner decision-making - a scoping review of contextual influence on antibiotic prescribing
title_fullStr	Context and general practitioner decision-making - a scoping review of contextual influence on antibiotic prescribing
title_full_unstemmed	Context and general practitioner decision-making - a scoping review of contextual influence on antibiotic prescribing
title_sort	context and general practitioner decision-making - a scoping review of contextual influence on antibiotic prescribing
publisher	BMC
publishDate	2021
url	https://doaj.org/article/6c8bc5b1063347999d884f4dc2bf297f
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Context and general practitioner decision-making - a scoping review of contextual influence on antibiotic prescribing

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