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1 Department of General Practice and Primary Health Care, Ghent University, Ghent, Belgium
2 Department of General Practice, Centre for Health Services Research, Cardiff University, Cardiff, UK
3 Department of Physical Therapy, Artevelde Hogeschool, Ghent, Belgium
CORRESPONDING AUTHOR: Mieke L. van Driel, MD, MSc, Department of General Practice and Primary Health Care, Ghent University, De Pintelaan 185, UZ-1K3, B-9000 Ghent, Belgium, mieke.vandriel{at}ugent.be
Annals Journal Club selection—see inside back cover or http://www.annfammed.org/AJC/.
PURPOSE Antibiotics are still overprescribed for self-limiting upper respiratory tract infections such as acute sore throat, and physicians mention patient’s desire for antibiotics as a driving force. We studied patients’ concerns when visiting their family physician for acute sore throat, more specifically the importance they attach to antibiotic treatment and pain relief.
METHODS Family physicians in 6 peer groups in Belgium participated in an observational postvisit questionnaire survey. Patients aged 12 years and older making an office visit for acute sore throat were invited to indicate the importance of different reasons for the visit.
RESULTS Sixty-eight family physicians provided data from 298 patients. The 3 most frequently endorsed reasons for visiting the physician were examination to establish the cause of the symptoms, pain relief, and information on the course of the disease. Hopes for an antibiotic ranked 11th of 13 items. Patients who considered antibiotics very/rather important valued pain relief significantly more than patients who considered them little/not important (P <.001). Patients who hoped for antibiotics felt more unwell (P <.001), had more faith in antibiotics to speed recovery (P <.001), and were less convinced that sore throat was a self-limiting disease (P <.012). A multivariate model, adjusted for age, sex, and educational status, showed that the desire for pain relief is a strong predictor of the hope to receive a prescription for antibiotics.
CONCLUSION Our study suggests that patients with acute sore throat and who hope for antibiotics may in fact want treatment for pain. Trials are needed to test whether exploring patients’ expectations about pain management and offering adequate analgesia can assist physicians in managing sore throats without prescribing antibiotics.
Key Words: Anti-bacterial agents • prescriptions • family practice • physician’s practice patterns • physician-patient relations • patient expectations • respiratory tract infections • evidence-based medicine
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  J. Matthys, M. De Meyere, M. L. van Driel, and A. De Sutter Differences Among International Pharyngitis Guidelines: Not Just Academic Ann. Fam. Med, September 1, 2007; 5(5): 436 - 443. [Abstract] [Full Text] [PDF]
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 M L van Driel, S Coenen, K Dirven, J Lobbestael, I Janssens, P Van Royen, F M Haaijer-Ruskamp, M De Meyere, J De Maeseneer, and T Christiaens What is the role of quality circles in strategies to optimise antibiotic prescribing? A pragmatic cluster-randomised controlled trial in primary care Qual. Saf. Health Care, June 1, 2007; 16(3): 197 - 202. [Abstract] [Full Text] [PDF]
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K. C. Stange On TRACK: The Search for the Holy Grail Ann. Fam. Med, January 1, 2007; 5(1): 84 - 85. [Full Text] [PDF]
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K. C. Stange In This Issue: Prescribing Drugs: What Do Patients and Pharmaceutical Companies Really Want? Ann. Fam. Med, November 1, 2006; 4(6): 482 - 483. [Full Text] [PDF]
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J. Hickner A New Look at an Old Problem: Inappropriate Antibiotics for Acute Respiratory Infections Ann. Fam. Med, November 1, 2006; 4(6): 484 - 485. [Full Text] [PDF]
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Annals Journal Club: Antibiotics for Common Respiratory Infections Ann. Fam. Med, November 1, 2006; 4(6): iii - iii. [Full Text] [PDF]
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