[Utilization and reporting of qualitative research methods in health services research in Germany: A scoping review on original research publications (2010-2019)]. / Anwendung und Darstellung qualitativer Methoden in der Versorgungsforschung in Deutschland: ein Scoping Review zu Primärstudien (2010­2019).

BACKGROUND: Qualitative research methods offer a unique perspective on health care services. However, little is known about the actual application of qualitative methods in health services research. Therefore, the aim of this study was to gain an overview of volume and variety of the use of qualitative research methods in health services research in Germany. METHODS: By means of a scoping review, a systematic literature search of the database PubMed was conducted in September 2020. We included (1) qualitative studies in (2) a health services setting (3) in Germany, (4) published in either German or English as (5) original research in a journal (6) between 2010 and 2019. After removing duplicates, tandem teams of researchers first performed a title and abstract screening, followed by a full text screening. Data was extracted by using a category grid considering research focus, study design and reporting. RESULTS: In total, 759 articles were included in the title and abstract screening. After applying the exclusion criteria, 97 articles were included in the data extraction. The studies investigating mainly subjective perspectives of different stakeholders, especially physicians and patients, covered 13 areas of health care. Interviews were the dominant form of data collection (n=64). Data analysis was mainly conducted using content analysis (n=65). CONCLUSION: A clear absolute increase in publications since the mid-2010s can be observed. At the same time, there has been a strong tendency towards certain methods being used for data collection and analysis. Compared to reporting standards and guidelines (e.g., COREQ), incomplete reporting of research methods has been noted. The results show that both an extension of the range of methods and the quality of reporting need to be discussed.

Contextual factors influencing physicians' perception of antibiotic prescribing in primary care in Germany - a prospective observational study.

BACKGROUND: Antimicrobial resistance is a worldwide challenge for health services and systems alike. To reduce the overuse of antibiotics, multifaceted interventions are often used to achieve sustainable effects. It can be assumed that these effects are influenced by contextual factors. Embedded in the cluster randomized trial ARena (Sustainable reduction of antibiotic-induced antimicrobial resistance), the aim of this present study was to identify contextual factors associated with practitioners' perceptions of antibiotic prescribing in German primary health care. METHODS: In a prospective observational study, data were generated in a three-wave survey study between January 2018 and July 2019. Analysis was performed using logistic regression models. The outcome of interest was the physician perceived impact of participating in the ARena project on decision-making regarding antibiotic prescribing, the independent variables of interest included individual characteristics, intervention arm allocation, primary care network (PCN) environment and characteristics of the medical practice. RESULTS: Forty Six point eight percent (n = 126) of participants indicated to have perceived an impact on their decision-making regarding antibiotic prescribing by participating in the ARena project. Bivariate logistic regression analyses indicated that work experience (odds ratio (OR) 1.05, 95% confidence interval (CI) 1.006-1.103), PCN environment (OR 2.06, 95% CI 1.256-3.363), structural conditions (OR 1.66, 95% CI 1.161-2.371), environment of existing processes (OR 1.46, 95% CI 1.011-2.094), and externally defined general conditions (OR 1.57, 95% CI 1.035-2.378) were associated with physicians' perceived impact of participating in the ARena project on decision-making regarding antibiotic prescribing. In the multivariable logistic regression analysis, only work experience OR 1.05 (95% CI 1.001-1.104) continuously showed a significant influence. CONCLUSIONS: This study indicates that contextual factors at individual, practice, and system level influence physicians' perceptions of antibiotic prescribing. Longer work experience appeared to be a significant influencing factor to be considered in antimicrobial stewardship programs. TRIAL REGISTRATION: ISRCTN, ISRCTN58150046 (registered 13.09.2017).