The use of interventions among GP registrars to improve antibiotic prescribing behaviours: a systematic review protocol

In 2015 the World Health Organisation designated antimicrobial resistance (AMR) as a threat to global health. More recently it has been projected that if left unchecked AMR will become the leading cause of death worldwide by 2050 with an estimated cost of US$3.5 billion annually. The prescription and consumption of antibiotics has been identified as a key factor in the advance of AMR. As the majority of antibiotics prescribed for human consumption originate in Primary Care / General Practice settings it is important to focus the lens of behavioural science on professional behaviours that will improve the current and future antibiotic prescribing behaviours of Primary Care physicians / GPs. Despite the increase in the promotion of appropriate antibiotic prescribing behaviours in General Practice inappropriate prescribing still occurs due to a number of different factors and it has been found that, GPs’ antibiotic prescribing practices, once established, tend to remain consistent. GP registrars have been identified as engaging in comparable inappropriate antibiotic prescribing behaviours to established GPs. By engaging with GP registrars at this point of their career stage and by focusing on their antibiotic prescribing behaviours during their training we are afforded a unique opportunity to address inappropriate antibiotic prescribing behaviours in a formative phase of professional development before they crystallise into habitual patterns of prescribing. This systematic review will form the basis of the later research studies exploring the feasibility of using a peer led educational intervention to address inappropriate antibiotic prescribing among GP registrars in Irish General Practice.