Martijn Sijbom

121 Cues to improve antibiotic-allergy registration: A mixed-method stu 5 Statistical analysis Analyses were conducted using SPSS, version 25. The prevalence of patients with an antibiotic allergy registration was calculated for all registrations and for the five most frequently prescribed antibiotics groups. Unpaired t-tests were applied to compare continuous variables with normal distributions and reported as a 95% confidence interval (95% CI). Age was reported as a median and with an interquartile range (IQR). Determinants of correct antibiotic allergy registrations Semi-structured interviews To identify determinants of correct antibiotic allergy registration, five interviewers (KB, ML, YA, BH and MS) conducted semi-structured interviews with primary care, hospital care, elderly care and pharmacy healthcare workers in the Leiden and The Hague regions of The Netherlands. This region encompasses a large metropolitan area. This part of the study was conducted and reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist (S2 Table) (13). Participants were selected using a purposive sampling method to represent the healthcare workers in the region who encounter antibiotic allergy registrations, taking into account differences in experience and sex and asked to participate via e-mail or face-to-face (14). The semi-structured interview (S3 Table) contained questions based on themes from a checklist by Flottorp et al. (15). This checklist describes themes that obstruct or facilitate improvements in healthcare: guideline factors, individual healthcare professional factors, patients factors, professional interaction, incentives and resources, capacity for organisational change, social, political and legal factors. A pilot interview was performed and followed by semi-structured interviews that were conducted until saturation of answers occurred, with a minimum of 10 interviews (14). Saturation was defined as no new information in three consecutive interviews. At saturation, answers were considered to give a complete overview of all possible answers. All interviews were digitally recorded after obtaining permission from interviewees and transcribed verbatim. Transcripts were uploaded in Atlas.Ti, version 8, and coded. A three-step plan was used for content analysis. The first step consisted of labelling individual quotes. In step two, labels were coded by theme. In the third and final step, labelled quotes were identified and coded per determinant, and then categorised as either facilitator and barrier. Two researchers (K.B, M.S.) independently performed

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