Cardiff University | Prifysgol Caerdydd ORCA
Online Research @ Cardiff 
WelshClear Cookie - decide language by browser settings

C-Reactive Protein-guided antibiotic prescribing for COPD exacerbations: a qualitative evaluation

Phillips, Rhiannon ORCID:, Stanton, Helen, Singh-Mehta, Amina ORCID:, Gillespie, David ORCID:, Bates, Janine, Gal, Micaela ORCID:, Thomas-Jones, Emma, Lowe, Rachel, Hood, Kerenza ORCID:, Llor, Carl, Melbye, Hasse, Cals, Jochen, White, Patrick, Butler, Christopher and Francis, Nick 2020. C-Reactive Protein-guided antibiotic prescribing for COPD exacerbations: a qualitative evaluation. British Journal of General Practice 70 (696) , e505-e523. 10.3399/bjgp20X709865

[thumbnail of C-+Reactive+Protein+guided+antibiotic+prescribing+for+COPD+exacerbations+a+qualitative+evaluation+-+BJCP (1).pdf] PDF - Accepted Post-Print Version
Download (283kB)


Background Antibiotics are prescribed to >70% of patients presenting in primary care with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The PACE randomised controlled trial found that a C-reactive protein point-of-care test (CRP-POCT) management strategy for AECOPD in primary care resulted in a 20% reduction in patient-reported antibiotic consumption over 4 weeks. Aim To understand perceptions of the value of CRP-POCT for guiding antibiotic prescribing for AECOPD; explore possible mechanisms, mediators, and pathways to effects; and identify potential barriers and facilitators to implementation from the perspectives of patients and clinicians. Design and setting Qualitative process evaluation in UK general practices. Method Semi-structured telephone interviews with 20 patients presenting with an AECOPD and 20 primary care staff, purposively sampled from the PACE study. Interviews were audio-recorded, transcribed, and analysed using framework analysis. Results Patients and clinicians felt that CRP-POCT was useful in guiding clinicians’ antibiotic prescribing decisions for AECOPD, and were positive about introduction of the test in routine care. The CRP-POCT enhanced clinician confidence in antibiotic prescribing decisions, reduced decisional ambiguity, and facilitated communication with patients. Some clinicians thought the CRP-POCT should be routinely used in consultations for AECOPD; others favoured use only when there was decisional uncertainty. CRP-POCT cartridge preparation time and cost were potential barriers to implementation. Conclusion CRP-POCT-guided antibiotic prescribing for AECOPD had high acceptability, but commissioning arrangements and further simplification of the CRP-POCT need attention to facilitate implementation in routine practice.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Centre for Trials Research (CNTRR)
Publisher: Royal College of General Practitioners
ISSN: 0960-1643
Date of First Compliant Deposit: 6 January 2020
Date of Acceptance: 23 December 2019
Last Modified: 05 Jan 2024 08:14

Citation Data

Cited 3 times in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item Edit Item


Downloads per month over past year

View more statistics