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Barriers and facilitators of evidence-based management of patients with bacterial infections among general dental practitioners: a theory-informed interview study

Overview of attention for article published in Implementation Science, January 2016
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  • Above-average Attention Score compared to outputs of the same age (51st percentile)

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Title
Barriers and facilitators of evidence-based management of patients with bacterial infections among general dental practitioners: a theory-informed interview study
Published in
Implementation Science, January 2016
DOI 10.1186/s13012-016-0372-z
Pubmed ID
Authors

Rumana Newlands, Eilidh M. Duncan, Maria Prior, Paula Elouafkaoui, Andrew Elders, Linda Young, Jan E. Clarkson, Craig R. Ramsay, for the Translation Research in a Dental Setting (TRiaDS) Research Methodology Group

Abstract

General dental practitioners (GDPs) regularly prescribe antibiotics to manage dental infections although most infections can be treated successfully by local measures. Published guidance to support GDPs to make appropriate prescribing decisions exists but there continues to be wide variation in dental antibiotic prescribing. An interview study was conducted as part of the Reducing Antibiotic Prescribing in Dentistry (RAPiD) trial to understand the barriers and facilitators of using local measures instead of prescribing antibiotics to manage bacterial infections. Thirty semi-structured one-to-one telephone interviews were conducted using the Theoretical Domains Framework (TDF). Responses were coded into domains of the TDF and sub-themes. Priority domains (high frequency: ≥50 % interviewees discussed) relevant to behaviour change were identified as targets for future intervention efforts and mapped onto 'intervention functions' of the Behaviour Change Wheel system. Five domains (behavioural regulation, social influences, reinforcement, environmental context and resources, and beliefs about consequences) with seven sub-themes were identified as targets for future intervention. All participants had knowledge about the evidence-based management of bacterial infections, but they reported difficulties in following this due to patient factors and time management. Lack of time was found to significantly influence their decision processes with regard to performing local measures. Beliefs about their capabilities to overcome patient influence, beliefs that performing local measures would impact on subsequent appointment times as well as there being no incentives for performing local measures were also featured. Though no knowledge or basic skills issues were identified, the participants suggested some continuous professional development programmes (e.g. time management, an overview of published guidance) to address some of the barriers. The domain results suggest a number of intervention functions through which future interventions could change GDPs' antibiotic prescribing for bacterial infections: imparting skills through training, providing an example for GDPs to imitate (i.e. modelling) or creating the expectation of a reward (i.e. incentivisation). This is the first theoretically informed study to identify barriers and facilitators of evidence-based management of patients with bacterial infections among GDPs. A pragmatic approach is needed to address the modifiable barriers in future interventions intended to change dentists' inappropriate prescribing behaviour.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 118 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 118 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 20 17%
Student > Ph. D. Student 20 17%
Student > Doctoral Student 13 11%
Student > Master 13 11%
Student > Bachelor 10 8%
Other 18 15%
Unknown 24 20%
Readers by discipline Count As %
Medicine and Dentistry 35 30%
Nursing and Health Professions 16 14%
Social Sciences 8 7%
Psychology 8 7%
Agricultural and Biological Sciences 3 3%
Other 14 12%
Unknown 34 29%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 February 2016.
All research outputs
#13,379,720
of 22,842,950 outputs
Outputs from Implementation Science
#1,406
of 1,721 outputs
Outputs of similar age
#189,413
of 396,346 outputs
Outputs of similar age from Implementation Science
#52
of 60 outputs
Altmetric has tracked 22,842,950 research outputs across all sources so far. This one is in the 41st percentile – i.e., 41% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,721 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.7. This one is in the 17th percentile – i.e., 17% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 396,346 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 51% of its contemporaries.
We're also able to compare this research output to 60 others from the same source and published within six weeks on either side of this one. This one is in the 13th percentile – i.e., 13% of its contemporaries scored the same or lower than it.