Inpatients' willingness to accept antibiotic intravenous-to-oral switch therapy and its influencing factors: a qualitative study based on the Health Belief Model.

BACKGROUND

Antimicrobial stewardship emphasizes the timely transition from intravenous to oral antibiotic therapy to reduce the risk of catheter-associated infections and shorten hospital stays. However, the overuse of intravenous antibiotics remains a significant issue in China. Understanding the factors that influence patients' willingness to accept intravenous-to-oral switch (IVOS) therapy from their perspective is essential. This study aims to explore inpatients' willingness to accept IVOS therapy and its potential influencing factors, based on the Health Belief Model (HBM), providing evidence for the development of more effective intervention strategies.

METHODS

Between June and July 2025, a qualitative study guided by the HBM was conducted at a tertiary hospital in China. Fifteen inpatients receiving antibiotic therapy from five wards with high rates of intravenous antibiotic use were purposively selected for semi-structured interviews. Data were thematically analyzed and reported in accordance with the COREQ guidelines.

RESULTS

The study identified two themes and nine subthemes: (1) motivators to accept IVOS therapy (perceived benefits, high perceived severity, concerns about infusion safety, and action cues), (2) barriers to accept IVOS therapy (concerns about oral antibiotic effectiveness, low perceived susceptibility, low perceived severity, the "anti-inflammatory drug" label, and self-efficacy).

CONCLUSION

This study indicates that patients lack sufficient awareness of the efficacy of oral antibiotics and the severity of antimicrobial resistance. Targeted interventions, particularly public education initiatives, can improve patient understanding of these issues, encourage more informed therapy decisions, and potentially increase acceptance of IVOS therapy.