RT Journal Article
SR Electronic
T1 Reducing Expectations for Antibiotics in Patients With Upper Respiratory Tract Infections: A Primary Care Randomized Controlled Trial
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 232
OP 239
DO 10.1370/afm.2672
VO 19
IS 3
A1 Perera, Anna Ishani
A1 Thomas, Mark Greenslade
A1 Petrie, Keith James
A1 Frater, Janet
A1 Dang, Daniel
A1 Schache, Kiralee Ruth
A1 Akroyd, Amelia Frances
A1 Ritchie, Stephen Robert
YR 2021
UL http://www.annfammed.org/content/19/3/232.abstract
AB PURPOSE Many family practitioners prescribe antibiotics for patients with upper respiratory tract infections (URTIs) to meet patients’ expectations. We evaluated the impact of providing brief tablet-based information about antibiotic treatment of URTIs on patients’ expectations for antibiotics and on family practitioners’ antibiotic-prescribing behavior.METHODS We performed a 3-arm randomized controlled trial among patients presenting with URTIs at 2 urban family practices in Auckland, New Zealand, during winter 2018. Participants were randomly allocated to view a presentation about the futility of antibiotic treatment of URTIs, the adverse effects associated with antibiotics, or the benefits of healthy diet and exercise (active control), immediately before their consultation. Before and after viewing the presentations, participants used a Likert scale to rate the strength of their belief that antibiotics are effective for treating URTIs and of their desire to be prescribed an antibiotic. Patients reported whether an antibiotic had been prescribed, and pharmacy dispensing records were reviewed to determine whether an antibiotic was dispensed.RESULTS Participants who viewed either the futility or the adverse effects presentation had greater reductions in their expectations to receive antibiotics than the control group. The mean reduction (95% CI) was 1.1 (0.8-1.3) for the futility group, 0.7 (0.4-0.9) for the adverse effects group, and 0.1 (0-0.3) for the control group (Cohen d = 0.7; P <.001). There was no significant difference among the 3 groups with regard to antibiotic prescribing (P = .84) or dispensing (P = .43).CONCLUSIONS A brief tablet-based waiting room intervention significantly reduced participants’ expectations about receiving antibiotics for URTI immediately before their family practitioner consultation. The intervention did not influence family practitioner prescribing behavior, however.