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Qualitative interview study of parents’ perspectives, concerns and experiences of the management of lower respiratory tract infections in children in primary care
  1. Amy Halls1,
  2. Catherine van’t Hoff2,
  3. Paul Little1,
  4. Theo Verheij3,
  5. Geraldine M Leydon1
  1. 1 Faculty of Medicine, Academic Unit of Primary Care and Population Sciences, Aldermoor Health Centre, University of Southampton, Southampton, UK
  2. 2 Education Centre, Royal Bournemouth Hospital, Bournemouth, UK
  3. 3 Department of General Practice, University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
  1. Correspondence to Professor Geraldine M Leydon; gerry{at}


Objective To explore parents’ perspectives, concerns and experiences of the management of lower respiratory tract infections (LRTIs) in children in primary care.

Design Qualitative semistructured interview study.

Setting UK primary care.

Participants 23 parents of children aged 6 months to 10 years presenting with LRTI in primary care.

Method Thematic analysis of semistructured interviews (either in person or by telephone) conducted with parents to explore their experiences and views on their children being prescribed antibiotics for LRTI.

Results Four major themes were identified and these are perspectives on: (1) infection, (2) antibiotic use, (3) the general practitioner (GP) appointment and (4) decision making around prescribing. Symptomatic relief was a key concern: the most troublesome symptoms were cough, breathing difficulty, fever and malaise. Many parents were reluctant to use self-care medication, tended to support antibiotic use and believed they are effective for symptoms, illness duration and for preventing complications. However, parental expectations varied from a desire for reassurance and advice to an explicit preference for an antibiotic prescription. These preferences were shaped by: (1) the age of the child, with younger children perceived as more vulnerable because of their greater difficulty in communicating, and concerns about rapid deterioration; (2) the perceived severity of the illness; and (3) disruption to daily routine. When there was disagreement with the GP, parents described feeling dismissed, and they were critical of inconsistent prescribing when they reconsult. When agreement between the parent and the doctor featured, parents described a feeling of relief and legitimation for consulting, feeling reassured that the illness did indeed warrant a doctor’s attention.

Conclusion Symptomatic relief is a major concern for parents. Careful exploration of expectations, and eliciting worries about key symptoms and impact on daily life will be needed to help parents understand when a no antibiotic recommendation or delayed antibiotic recommendation is made.

  • primary care
  • qualitative research
  • antibiotics
  • interviews

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  • Contributors GML was responsible for all aspects of the study including design, data analysis and interpretation, and manuscript preparation. AH and CvH collected, analysed and interpreted the data, and prepared the manuscript led by GML. PL is the principal investigator of a larger affiliated study, Antibiotics for lower Respiratory Tract Infection in Children presenting in Primary Care (ARTIC PC). PL and TV were involved in the generation of the study idea and design, and manuscript comments and revisions.

  • Funding This project was funded by the National Institute for Health Research Health Technology Assessment Programme (project number 13/34/64).

  • Competing interests None declared.

  • Ethics approval NISCHR RES.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No further data are available as this was not part of the ethics approval.

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