title: Delayed prescribing for upper respiratory tract infections: a qualitative study of GPs' views and experiences.
abstract: BACKGROUND
  Delayed prescribing has been promoted as a strategy that meets patients' expectations and helps to avoid unnecessary use of antibiotics in upper respiratory tract infections.
  
  
  OBJECTIVE
  To explore GPs' views on and experiences with delayed prescribing in patients with acute upper respiratory tract infections.
  
  
  METHODS
  Qualitative study involving focus groups. Setting Norwegian general practice.
  
  
  METHODS
  Qualitative analysis of data collected from five focus groups comprising 33 GPs who took part in a quality-improvement programme of antibiotic prescribing.
  
  
  RESULTS
  The views of GPs differed on the usefulness of delayed prescribing. GPs who endorsed the strategy emphasised shared decision making and the creation of opportunities for educating patients, whereas GPs who were negative applied the strategy mainly when being pressed to prescribe. Mild and mainly harmless conditions of a possible bacterial origin, such as acute sinusitis and acute otitis, were considered most suitable for delayed prescribing. A key argument for issuing a wait-and-see prescription was that it helped patients avoid seeking after-hours care. For issuing a wait-and-see prescription, the GPs required that the patient was 'knowledgeable', able to understand the indications for antibiotics, and motivated for shared decision making. GPs emphasised that patients should be informed thoroughly when receiving a wait-and-see prescription.
  
  
  CONCLUSIONS
  Not all GPs endorse delayed prescribing; however, it appears to be a feasible approach for managing patients with early symptoms of mild upper respiratory tract infections of a possible bacterial origin. Informing the patients properly while issuing wait-and-see prescriptions is essential.
authors.affiliation: Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Norway. sigurd.hoye@medisin.uio.no
authors.forename: Sigurd
authors.initials: S
authors.lastname: Høye
authors.forename: Jan
authors.initials: J
authors.lastname: Frich
authors.forename: Morten
authors.initials: M
authors.lastname: Lindbœk
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D004812:Epidemiologic Methods; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012141:Respiratory Tract Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents