Cardiff University, CU, United Kingdom

Scientific contact person: Prof. Christopher Butler
University: Cardiff University, Dept. of Primary Care & Public Health

 


Description of the Institute
The Department of Primary Care & Public Health at Cardiff University will be leading this work package. This Department has been rated 5 in all of the UK Research Assessment Exercises, and enjoys an international reputation for three decades of research work in the area of common infections in primary care.  Our expertise in the complex field of physician behaviour change is well recognised, and we were one of the first departments of general practice in Europe to engage patients using qualitative research methods to ensure their perspectives on health care is heard. Pioneering clinical trials and observational studies have been done in the field. Crucially, we have also made a major contribution using qualitative methods to research physicians’ and patients’ understanding and beliefs about treatment of common infections, antibiotic use and antibiotic resistance.  A paper published in 1998, for example, in the British Medical Journal helped formulate the critical acknowledgement that more guidelines alone would be unlikely to change prescribing behaviour, and that antibiotics prescribing decisions are far more complex than many hitherto thought.  This study has been cited over 140 times in the literature, including by the WHO Global Strategy on Containment of Antibiotic Resistance.  Ongoing relevant studies in the Department include qualitative studies of lay perceptions of antibiotic use and treatment of common infections, and professionals’ understanding and beliefs of the use of quinolones. Quantitative studies include clinical trials of lower respiratory tract infections and of promoting non-antibiotic management of children with upper respiratory tract infection. The Department of Primary Care & Public Health is co-located with the Clinical Epidemiology Interdisciplinary Research Group which brings together some 150 researchers with relevant expertise. The multi-disciplinary team includes general practitioners, epidemiologists, survey design experts, medical sociologists and qualitative researchers, and one of the main theme areas is applied infection, which covers the epidemiology, diagnosis, decision making, treatment and prevention of infection and antibiotic resistance as well as the behaviour change required to modify clinical practice.

Qualifications and contribution to the project
The Cardiff research group will lead work package 2. For the quantitative survey, the group will take charge of designing, administering and analysing relevant questionnaires, including the scenario-based instrument for determining variations in the management of common infections. Regarding the qualitative interview study, the research group will take charge of planning this including development of the topic guides, planning and assembling the sample, conducting the interviews, transcribing them, and conducting analyses. These two aspects of this work package are crucial to the topic of this call.  Unless variation in presentation, management and outcome for common infections is accurately described, and unless we achieve a deep understanding of what underlies this variation, successful interventions that are innovative and tackle both the perspectives of patients and clinicians will not be developed.  So a comprehensive description and deep understanding of variation is central to the aims of the project. Our research group is internationally recognised for successfully producing high quality outputs using both quantitative and qualitative methods in the filed on antibiotic use and antimicrobial resistance in primary care that are useful in informing intervention development.

Scientific contact person: Prof. Christopher Butler
University: Cardiff University, Dept. of Primary Care & Public Health

 


Description of the Institute
The Department of Primary Care & Public Health at Cardiff University will be leading this work package. This Department has been rated 5 in all of the UK Research Assessment Exercises, and enjoys an international reputation for three decades of research work in the area of common infections in primary care.  Our expertise in the complex field of physician behaviour change is well recognised, and we were one of the first departments of general practice in Europe to engage patients using qualitative research methods to ensure their perspectives on health care is heard. Pioneering clinical trials and observational studies have been done in the field. Crucially, we have also made a major contribution using qualitative methods to research physicians’ and patients’ understanding and beliefs about treatment of common infections, antibiotic use and antibiotic resistance.  A paper published in 1998, for example, in the British Medical Journal helped formulate the critical acknowledgement that more guidelines alone would be unlikely to change prescribing behaviour, and that antibiotics prescribing decisions are far more complex than many hitherto thought.  This study has been cited over 140 times in the literature, including by the WHO Global Strategy on Containment of Antibiotic Resistance.  Ongoing relevant studies in the Department include qualitative studies of lay perceptions of antibiotic use and treatment of common infections, and professionals’ understanding and beliefs of the use of quinolones. Quantitative studies include clinical trials of lower respiratory tract infections and of promoting non-antibiotic management of children with upper respiratory tract infection. The Department of Primary Care & Public Health is co-located with the Clinical Epidemiology Interdisciplinary Research Group which brings together some 150 researchers with relevant expertise. The multi-disciplinary team includes general practitioners, epidemiologists, survey design experts, medical sociologists and qualitative researchers, and one of the main theme areas is applied infection, which covers the epidemiology, diagnosis, decision making, treatment and prevention of infection and antibiotic resistance as well as the behaviour change required to modify clinical practice.

Qualifications and contribution to the project
The Cardiff research group will lead work package 2. For the quantitative survey, the group will take charge of designing, administering and analysing relevant questionnaires, including the scenario-based instrument for determining variations in the management of common infections. Regarding the qualitative interview study, the research group will take charge of planning this including development of the topic guides, planning and assembling the sample, conducting the interviews, transcribing them, and conducting analyses. These two aspects of this work package are crucial to the topic of this call.  Unless variation in presentation, management and outcome for common infections is accurately described, and unless we achieve a deep understanding of what underlies this variation, successful interventions that are innovative and tackle both the perspectives of patients and clinicians will not be developed.  So a comprehensive description and deep understanding of variation is central to the aims of the project. Our research group is internationally recognised for successfully producing high quality outputs using both quantitative and qualitative methods in the filed on antibiotic use and antimicrobial resistance in primary care that are useful in informing intervention development.

Christopher Butler