The impact of an electronic learning intervention to support appropriate antibiotic prescribing behaviour by non-medical prescribers for upper respiratory tract infections in the primary care setting: a feasibility study

Background: Interventions are available for general practitioners to support appropriate antibiotic prescribing behaviour for common, acute, uncomplicated, self-limiting upper respiratory tract infections (URTIs). Non-medical prescribers frequently manage these conditions, but no such interventions exist for these groups. This study aimed to assess the feasibility and perceived impact of a theory-based electronic learning intervention designed to support appropriate antibiotic prescribing by non-medical prescribers for URTIs in primary care settings. Methods: A repeated measures, electronic survey design was used, with data collection occurring pre-intervention (stage 1), post-intervention (stage 3), and at a 3-month follow-up (stage 4). The intervention’s usefulness was assessed by analysing prescribers’ self-reported confidence and knowledge in treating patients with URTIs, as well as their views on the relevance of the intervention to their work. The influence of the intervention on prescribing behaviour was evaluated by examining prescribers’ perceived capabilities, opportunities, and motivations (COM) in the pre-intervention questionnaire and at follow-up. Feasibility outcome measures included recruitment, retention, and engagement with the intervention. Results: Twenty-one participants (n = 18 nurses, n = 1 pharmacist, and n = 2 paramedics) responded to the recruitment materials, followed the weblink to the survey, and completed the intervention over the 2-month recruitment period. Outcome data for 21 participants were available for pre- and post intervention (stage 1 & 3) and 11 (52%) participants completed follow-up (stage 4). Behavioural practice (information and support for self-management of URTIs) and perceived COM in relation to prescribing for patients with URTIs all increased at follow-up. Mean confidence scores were high at pre- and post-intervention stages but showed a slight decrease at follow-up. The intervention was reported to be useful and applicable to participants’ practice. Conclusion: It was feasible to recruit the target sample, and participants engaged well with the intervention. However, further consideration is needed for recruiting pharmacists and paramedics and developing a retention strategy for the follow-up survey. Behaviour and COM influences on behaviour changed positively from before to after the intervention. Future work should consider using the intervention in nursing and pharmacy undergraduate programmes, with students on prescribing programmes, and with other non-medical prescribers such as paramedic and physiotherapist prescribers.