Nordic veterinarians' threshold for medical treatment of dairy cows, influence on disease recording and medicine use: mild clinical mastitis as an example.

National databases for dairy cows in the four Nordic countries, Denmark, Finland, Norway and Sweden, have been found to capture varying proportions of disease events on farm. A variation in the thresholds of veterinarians to initiate medical treatment may be a reason for this. Studying these thresholds may increase the understanding of prudent use of antibiotics. The primary objective of this study was to investigate whether Nordic veterinarians, on a between country-level, vary in their intention to start medical treatment of a dairy cow with mild clinical mastitis, on the same day as making the diagnosis. The threshold for initiating treatment was quantified as an intention score. Secondary, underlying behavioural components of the intention score was studied within each country. A social psychology model, the Theory of Planned Behaviour (TPB), was used to design a questionnaire that was distributed to 1047 veterinarians in cattle practice in the four countries during autumn 2010. The response rate was around 50% in all the countries, and 543 observations were retained for analysis. The between-country differences in intention were tested with one-way analysis of variance. Multivariable linear regression was used to estimate the proportion of variability in intention explained by the three behavioural components, attitude, subjective norm and perceived behavioural control. The Spearman rank correlations between specific beliefs about the behaviour and intention scores were estimated to find beliefs of high influence on the decision to treat or not. Intention scores differed between all countries (p<0.05) except between NO and SE (p=0.06). The mean intention scores were 0.71, 0.42, 0.58 and 0.50 in DK, FI, NO and SE, respectively. As measured by the adjusted R(2) in linear regression models, the underlying behavioural components of the TPB explained 0.37, 0.41, 0.40 and 0.48 of the variation in intention scores in DK, FI, NO and SE, respectively. Attitude was the most important predictor in DK, NO and SE, but perceived behavioural control was most important in FI. In all countries the specific attitude belief of highest influence was that starting treatment the same day as diagnosing a case of mild clinical mastitis gives the best result, compared to delaying treatment. The varying intentions of veterinarians to initiate medical treatment are likely to influence centrally registered mastitis incidence. This study has given an improved understanding of this behaviour, which may be useful in intervention studies or campaigns aiming at prudent use of antibiotics on dairy farms.