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Table 3 Analytical framework for developing categories and themes for patients’ experiences

From: Patient engagement with antibiotic messaging in secondary care: a qualitative feasibility study of the ‘review and revise’ experience

CategoryDefinitionExample quote
Theme 1: leaflet acceptability and impact on perceptions of treatment
Positive perceptions of review and revisePositive feedback given about the leaflet as an introduction to the ‘review and revise’ process. Also includes discussion about recommending the leaflet to others and the overall relevance of the leaflet.‘I think it makes you feel better knowing that you’re being checked on and deciding whether we’re going to need all these antibiotics all the time.’ (P9, female, 81)
New concerns raised about resistanceAny concerns or questions that patients discussed regarding antibiotic resistance as well as how this may impact friends and family.‘The one thing that would probably worry me more than anything is that the more antibiotics you take the more likely you are to spread them to other people, such as your family and friends.’ (P3, male, 78)
Timing of when leaflet receivedDiscussion about perceptions of the impact that timing of the leaflet had on their input into treatment as well as perceived relevance of the leaflet.‘I found that where I had the leaflet it was very helpful in actually talking to them [HCPs] about what I was being specifically treated for.’ (P3, male, 78)
Theme 2: experience of review and revise process
Positive perceptions of initial antibiotic prescribingPositive perceptions about how antibiotics were initially prescribed, including reasons for hospitalisation, drug mode of delivery, awareness (or not) of initial prescription and any information given about prescription and/or treatment.‘…when they put me on the antibiotics they were telling me exactly what they for, how long I was going to be on for, and what they was doing, and if I’ve got any problems with them at all let them know and they’d stop them.’ (P5, male, 77)
Experience of prescription changesFeedback about any changes to antibiotic prescription. Includes discussion about any diagnostic testing and results, changes to drug mode of delivery and the efficacy of treatment.‘They started me on antibiotics and I had about 2 or 3 that day and then 2 in the morning, and then when they gave me an x-ray they realised it wasn’t a chest infection, they think it was a viral infection. So they cancelled the antibiotics.’ (P4, female, 51)
Patient perceptions of input into treatmentAmount of input patients felt they had regarding antibiotic treatment. Reflections on whether they had the opportunity to ask questions or discuss treatment at the time of prescribing, or as any changes to treatment were made, up until the time of discharge.‘Anything I did want to know, people automatically told me if I had anything [medications], which was really good.’ (P14, female, 83)
Theme 3: existing knowledge of antibiotics
Positive past experience(s) of antibiotic treatmentAny positive past treatment experiences reported by patients. It includes aspects of how treatment was received, but also treatment efficacy.‘Well obviously, the only thing I use them for is if you’ve got an infection because then it kills the infection; it makes you well again. That’s the only thing I know about antibiotics.’ (P4, female, 51)
Negative past experience(s) of antibiotic treatmentAny negative past experiences of antibiotic treatment, with discussion including problems with treatment, particularly the experience of side effects.‘I agree that some antibiotics aren’t great, and I know in the past I’ve had antibiotics that upset your stomach and had to stop them or change them. So I’ve said in the past, don’t give me that one because I don’t like it.’ (P1, female, 50)
Existing concerns about antibiotic resistancePatients’ existing knowledge of antibiotic resistance and the concerns that they had about this.‘You can get immune to them if you take too many. I mean it’s pretty obvious, it’s like anything else, that they will stop working, that’s why I don’t like to take so many.’ (P2, female, 65)
Theme 4: trust in healthcare professionals
Positive existing relationship with HCPsPositive perceptions that patients have about their relationship with HCPs, including previous experience of care by GPs and pharmacists, as well as positive experiences of care during their recent hospital stay.‘The doctors and the hospital have been very good, because I have been admitted quite a few times. They don’t turn around and say oh no, not you again, they do treat me as a new patient every time.’ (P2, female, 65)
Willingness to take antibioticsSpecific discussions about being happy to take antibiotic medications in hospital, particularly as this is often life-saving and not always viewed as a ‘choice’ if patients want to recover.‘I understand the risk you have to take, but if you’re in a situation like I was, where it was life and death, you’re going to take a chance of taking antibiotics, because if I hadn’t taken them I would have died.’ (P7, male, 62)
Positive perceptions of HCPs as expertsPerception of HCPs as experts giving each patient the best possible treatment. Patients discussed being happy to follow expert HCP advice about antibiotic treatment, including treatment duration, changes to treatment, and not always needing to feel involved in initial antibiotic treatment decisions.‘I’d be quite happy to accept whatever a doctor prescribed for me, because they’re the experts and I am not.’ (P6, female, 91)