Antibiotics for coughing in general practice: A questionnaire study toquantify and condense the reasons for prescribing

被引:36
作者
Coenen S. [1 ]
Michiels B. [1 ]
Van Royen P. [1 ]
Van Der Auwera J.-C. [1 ]
Denekens J. [1 ]
机构
[1] Centre for General Practice, University of Antwerp-UIA, Antwerp
关键词
Focus Group; Antibiotic Treatment; Antibiotic Prescribe; Medical Reason; Patient Expectation;
D O I
10.1186/1471-2296-3-16
中图分类号
学科分类号
摘要
Background: Antibiotics are being overprescribed in ambulant care, especially for respiratory tract infections (RTIs). Gaining insight into the actual reasons for prescribing remains important for the design of effective strategies to optimise antibiotic prescribing. We aimed to determine items of importance for the antibiotic prescribing decision and to make them operational for an intervention trial. Methods: A postal questionnaire based upon focus group findings was sent to 316 Flemish general practitioners (GPs). On a verbal rating scale the GPs scored to what extent they consider the questionnaire items in decision making in case of suspected RTI in a coughing patient and how strongly the items support or counter antibiotic treatment. Factor analysis was used to condense the data. The relative importance of the yielded operational factors was assessed using Wilcoxon Matched Pairs test. Results: 59.5% completed the study. Response group characteristics (mean age: 42.8 years; 65.9% men) approximated that of all Flemish GPs. Participants considered all the items included in the questionnaire: always the operational factor 'lung auscultation', often 'whether or not there is something unusual happening' - both medical reasons - and to a lesser extent 'non-medical reasons' (P < 0.001). Non-medical as well as medical reasons support antibiotic treatment, but non-medical reasons to a lesser extent (P < 0.001). Conclusion: This study quantified, condensed and confirmed the findings of previous focus group research. Practice guidelines and interventions to optimise antibiotic prescribing have to take non-medical reasons into account.
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页码:1 / 10
页数:9
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  • [21] Macfarlane J., Lewis S.A., Macfarlane R., Holmes W., Contemporary use of antibiotics in 1089 adults presenting with acute lower respiratory tract illness in general practice in the U.K.: Implications for developing management guidelines, Respir Med, 91, pp. 427-434, (1997)
  • [22] Little P., Williamson I., Warner G., Gould C., Gantley M., Kinmonth A.L., Open randomised trial of prescribing strategies in managing sore throat, BMJ, 314, pp. 722-727, (1997)
  • [23] Cockburn J., Pit S., Prescribing behaviour in clinical practice: Patients' expectations and doctors' perceptions of patients' expectations - A questionnaire study, BMJ, 315, pp. 520-523, (1997)
  • [24] Britten N., Ukoumunne O., The influence of patients' hopes of receiving a prescription on doctors' perceptions and the decision to prescribe: A questionnaire survey, BMJ, 315, pp. 1506-1510, (1997)
  • [25] Dosh S., Hickner J., Mainous A.I., Ebell M., Predictors of antibiotic prescribing for nonspecific upper respiratory tract infections, acute bronchitis, and acute sinusitis, J Fam Pract, 49, pp. 407-414, (2000)
  • [26] Fahey T., Antibiotics for respiratory tract symptoms in general practice, Br J Gen Pract, 48, pp. 1815-1816, (1998)
  • [27] Managing cough as a defense mechanism and as a symptom. A consensus panel report of the American College of Chest Physicians, CHEST, 114, (1998)
  • [28] Huchon G., Woodhead M., Management of adult community-acquired lower respiratory tract infections, Eur Respir Rev, 8, pp. 391-426, (1998)
  • [29] BTS guidelines for the management of community acquired pneumonia in adults, Thorax, 56, (2001)
  • [30] Coenen S., Van Royen P., Michiels B., Denekens J., Promotion of rational antibiotic use in Flemish general practice: Implementation of a guideline for acute cough, Prim Care Respir J, 11, (2002)