Influence of patients' expectations on antibiotic management of acute lower respiratory tract illness in general practice: questionnaire study.

摘要: Abstract Objective: To assess patients9 views and expectations when they consult their general practitioner with acute lower respiratory symptoms the influence these have on management. Design: General practitioners studied consecutive, previously well adults recorded clinical data, certainty regarding prescribing decision, of non-clinical factors that decision. Patients completed a questionnaire at home after consultation. Setting: 76 doctors from suburban, inner city, rural practices. Subjects: 1014 eligible patients entered; 787 (78%) returned questionnaire. Main outcome measures: The patient, antibiotic prescription by doctor. Results: Most thought were caused an infection (662) antibiotics would help (656) had both wanted (564) expected (561) such prescription. 146 requested antibiotic, 587 received one. Of 643 who infection, 582 it help. Severity did not relate to wanting antibiotics. For those prescribed antibiotics, doctor definitely indicated in only 116 cases 126. Patient pressure most commonly influenced decision prescribe even indicated. Doctors considered 1% group whom patient receive much more likely express dissatisfaction. Dissatisfied reconsulted for same twice as often satisfied patients. Conclusion: presenting believe is problem answer. Patients9 significant prescribing, judges are Key messages Three quarters consulting tract illness though fifth think will help, want antibiotics; ask them doctors9 concern may otherwise reconsult powerful effect prescribe, consider be dissatisfied. frequently Terms chest bronchitis, which imply needing probably unhelpful. education effective altering cycle consultations