Too often physicians prescribe antibiotics based on the mistaken perception that patients want them, a new study finds.
This assumption leads to unnecessary antibiotic use, report researchers from Cardiff University and the University of Antwerp in the journal PLOS ONE.
Given the growing concern over the threat of antibiotic resistance—described as a “ticking time bomb” by Professor Dame Sally Davies, chief medical officer for England, earlier his year—the study’s findings are of particular importance in helping to identify where safe reductions in antibiotic prescribing could potentially be made.
As part of the study, patients were asked if they “expected”, “hoped for”, or “asked for” antibiotics when consulting their doctor for acute cough, as part of a study involving 3,402 patients across 13 countries.
“Expecting antibiotics” (patient’s perception of what the clinician might do) differs from “hoping for” an antibiotic prescription, and from expressing hope for an antibiotic prescription (asking for antibiotic treatment).
Acute cough is one of the most common reasons for consulting and for prescribing antibiotics in primary care, yet the study found that the time taken for patients to get better remained largely the same—whether or not they expected, hoped for, asked for and/or received a prescription for antibiotics.
Patient satisfaction with the consultation remained high, whether or not patients actually received a prescription from their doctor. However, those who had “hoped for” antibiotic treatment, but did not receive this, were less satisfied.
“The study provides clear evidence that patient views are not associated with illness severity, and is therefore unlikely to represent a rational reason for prescribing antibiotics,” says Nick Francis, from Cardiff University’s School of Medicine and a co-author of the study. “Moreover, clinicians are not good at correctly assessing patient views on use of antibiotics.
“We believe it is likely that satisfaction could have been increased through enhanced communication, as has been found in previous studies.”
The European Commission funded the study.
Source: Cardiff University