Antimicrobial resistance and physician prescribing of antibiotics in Alberta: a qualitative exploration

Antimicrobial resistance (AMR) is acknowledged by the World Health Organization as a top-ten danger to public health. In Canada, AMR accounted for over 12,900 deaths in 2019. Alarmingly, 80% of oral antibiotic prescriptions in Alberta, Canada are issued by physicians, with nearly 40% considered inappropriate. The College of Physicians & Surgeons of Alberta (CPSA) aims to address this with ‘MD Snapshot-Prescribing’, an interactive tool providing information on physicians’ prescribing. This study explores Alberta physicians’ views on antibiotic prescribing, AMR, and antimicrobial stewardship; and assesses the MD Snapshot’s impact on physician prescribing practices. This study employed focus group interviews with a purposive sample of physicians registered in Alberta. Virtual focus group sessions were conducted via ZOOM between May to June 2023. All interviews were recorded, transcribed, and subjected to thematic content analysis to extract meaningful insights. We conducted seven focus groups involving 21 physicians, revealing three major themes: physicians’ knowledge about AMR and stewardship; antibiotic prescribing practices; and insights from MD Snapshot-Prescribing. The study unveiled significant variability in antibiotic prescribing practices among physicians, influenced by factors including patient demographics, practice settings, and encountered health issues. MD Snapshot-Prescribing emerged as a valuable educational and self-reflection tool, informed a reduction in unnecessary antibiotic prescriptions and promoted evidence-based practices. The study found that targeted interventions by regulators can positively influence prescribing practices and produced recommendations for the CPSA to enhance future iterations of MD Snapshot-Prescribing by presenting antibiotic prescribing data by diagnosis, prescribers, practice settings, panel size, and specialty group. Not applicable.