Interactive booklet boosts parents’ RTI confidence

An interactive booklet given to parents in primary care can help them to be more knowledgeable and feel more confident about when and when not to consult a doctor for their child’s respiratory tract infections (RTIs).

In a previously published study, use of the 'When should I worry?' booklet was associated with a two-thirds reduction in antibiotic prescribing and a significant reduction in the number of parents who stated they would consult again.

Researchers, led by Nick Francis (Cardiff University, UK), now report through qualitative assessment that both parents and clinicians were accepting of the booklet and found that it provided a consistent message about the appropriate prescribing of antibiotics.

However, the research also highlighted that many clinicians found that lack of time, unfamiliarity with the booklet, and the need to change their approach to managing RTIs stood in the way of its proper use.

“Plans for wider implementation of the intervention in health care settings would need to address clinician-related barriers to implementation,” the team comments in BMC Family Practice.

They interviewed 20 parents and 13 clinicians who took part in the original trial. In the intervention group, clinicians were asked to use the interactive, 8-page booklet with patients, which includes information on the symptoms of RTIs, the usual course of illness, antibiotics, self-management, and when to seek help. Clinicians also received online training encouraging them to use the booklet during consultation.

At 1 to 4 months from the initial consultation, parents mostly had positive feedback about the booklet, describing it as “good,” “useful,” and “helpful,” although some reported finding the information obvious and unnecessary. Clinicians equally had positive impressions of the booklet and generally considered it well-designed and patient-friendly.

Both clinicians and parents reported greater awareness of the issue of antibiotic overuse following the intervention.

But there was considerable variation in how the booklet was used during consultations, with some parents not receiving the booklet at all, or receiving it without discussion, while other clinicians used the booklet in every consultation.

“[I]nteractive use of the booklet during consultations did not appear to be consistently happening in practice,” remark Francis et al, who note that difficulty finding the additional time required for consultation using this approach was a common theme among practitioners.

They write: “Engaging with clinicians and ensuring that the benefits of investing time in these consultations in terms of antibiotic stewardship and improved knowledge of managing RTIs is likely to be vital in encouraging wider adoption.”

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