Physicians’ perspectives on shared decision-making in antibiotic prescriptions for acute respiratory tract infections at a primary healthcare centre in ethiopia: a qualitative study

Shared decision-making (SDM) is a collaborative process in which healthcare providers and patients work together to make informed healthcare choices, significantly reducing unnecessary antimicrobial prescriptions by aligning treatment decisions with both clinical evidence and patient values. There is limited qualitative research exploring physicians' perspectives on its implementation in the study area. This study aims to explore physicians' perspectives and experience of SDM in the management of Acute Respiratory Tract Infections (ARTIs) at public primary healthcare centres. Purposive sampling was applied to recruit physicians from selected primary healthcare centres in the Amhara region of Ethiopia. The sample size was determined using the concept of data saturation. The data were collected through semi-structured interviews and analysed using thematic analysis with the assistance of NVivo software (version 14). Twenty physicians were interviewed, and four main themes were identified: (1) awareness and understanding of SDM; (2) perceived value of SDM; (3) barriers to implementing SDM; (4) facilitators to enhance SDM implementation. The study found that, despite its recognised benefits, SDM is not yet a routine practice in primary healthcare centres in the study area due to identified barriers. Addressing these challenges and implementing the solutions suggested by participants will be essential to realise the full benefits of SDM and strengthen antimicrobial resistance mitigation efforts.