Title
Understanding primary care perspectives on treatment options for skin and soft tissue infections (SSTIs)

Lead researcher
Dr Claire O’Neill, SEWTU, Cardiff University

Aim
This study is being undertaken to gain an understanding of primary care prescribers (general practitioners and nurse prescribers) views about the treatment of suspected SSTIs, including how challenging they perceive these treatment decisions to be, factors taken into account in making their treatment decisions and what influences their decision.
The current range of treatment options includes basic hygiene advice, anti-fungal and steroidal creams, topical or oral antibiotics, surgical treatments (incision and drainage), dressings, observation over time and/or referral to secondary care.
By the end of this research project we expect to have a better understanding of:

  1. the diagnostic processes used by general practitioners (GPs) when patients present with SSTIs in primary care;
  2. the elements of the decision making process used in treating SSTIs;
  3. the primary care GP perspective on the prescription of antibiotics for the treatment of SSTIs;
  4. the possibilities for future service developments that could support the diagnosis and treatment of SSTIs.

Background
The term skin and soft tissue infections (SSTIs) is used to describe a wide range of conditions ranging from uncomplicated skin infections including impetigo, erysipelas, folliculitis, furunculosis, and, in some cases, superficial cellulitis to more complicated conditions like cellulitis, lymphangitis, and carbuncles. Where these infections are suspected by the GP one possible treatment option is to prescribe antibiotics (very commonly flucloxacillin). Skin conditions are one of the most common reasons for patients to consult in primary care (Schofield et al, 2011). General practice is the first port of call for most patients with SSTIs that have not resolved with home or over the counter treatment or that are deemed to be worsening. While we know about the help-seeking behaviours of patients with these conditions, little is known about the decision-making processes of GPs in treating this group of patients. This is important, because, while most antibiotics are prescribed by general practitioners we know very little about their views or decision-making processes in relation to skin and soft tissue infections (SSTIs).

Study design summary
The proposed study is a qualitative focus group study with 48 GPs working in South Wales. Focus groups have been chosen as an effective way to explore the decision making process of these healthcare professionals (Bryman, 2008).

Total awarded
£9,883