The Article in Brief
Managing Expectations of Antibiotics for Upper Respiratory Tract Infections: A Qualitative Study
Mohammed Mustafa , and colleagues
Background A number of studies have looked at doctor visits in which antibiotics are expected by patients or parents but may not be indicated by the clinical findings. There have been few efforts, however, to ask family physicians about the ways in which they handle expectations for antibiotics. This study explores how and why family physicians elicit and address patient or parents' expectations for antibiotics in visits for upper respiratory tract infections.
What This Study Found Family physicians prefer not to explore patient expectations for antibiotics in a direct manner or early on in visits for upper respiratory tract infections, contrary to the advice of many communications experts. Clinicians prefer more indirect methods to explore treatment expectations in an effort to avoid conflict and potential threats to the ongoing physician-patient relationship and trust. They report using open questions and building a foundation for nonantibiotic management by using strategies to indicate their reasoning and influence expectations, including running commentary on physical examination findings.
Implications
- The authors suggest that interventions to promote appropriate antibiotic prescribing include a focus on training in communication skills that integrates indirect methods as a part of building collaborative physician-patient relationships and uses the running commentary of examination findings to facilitate participation in clinical decisions.