Consultation skills and antimicrobial stewardship: a mixed-method study on the challenges of appropriate prescribing among health professionals for sore throat in the UK primary care

Abstract

Background: Antimicrobial resistance poses a significant global health threat, driven in part by the overprescription of antibiotics for minor illnesses like sore throats. Sore throat is a common condition in primary care, which is usually self-limiting and low risk, but can rarely be associated with severe illness. Despite the availability of evidence-based guidelines, antibiotics are widely overprescribed in primary care. Aim: This study explores the experiences of healthcare providers managing sore throat to gain insight into the causes of overprescribing antibiotics and to assess potential interventions to improve prescribing practices in primary care. Design and setting: Online questionnaire surveying health care professionals in the UK primary care settings. Method: Self-reported online questionnaire-based research work using a mixed methods approach to explore the qualitative and quantitative findings. Quantitative data was analysed using Microsoft Excel, and thematic analysis was used to analyse qualitative data. Result: 23 participants answered the questionnaire. 48% of practitioners report prescribing antibiotics unnecessarily for sore throat due to patient pressure and diagnostic challenges. Non-physicians were more influenced by patient expectations. Diagnostic uncertainty and limited communication training hinder accurate decisions. Improving communication skills and using point-of-care testing are believed to be central to reducing overprescribing and supporting antimicrobial stewardship in primary care. Conclusion: This study highlights challenges healthcare professionals face in antibiotic prescribing for sore throat in UK primary care. The findings underscore the importance of shared decision-making and tailored communication strategies. Addressing these factors through targeted interventions and enhanced diagnostic support could improve antimicrobial stewardship and reduce overprescribing in primary care settings.