Study: Patients less satisfied with doctors who prescribe fewer antibiotics

By Stephen Feller

LONDON, Dec. 7 (UPI) -- Patients who go to the doctor sick with an expectation of receiving antibiotics are less satisfied with their care, according to a new study in England.

Researchers at King's College in London found just over half of patients were inappropriately prescribed antibiotics by general practitioners. Antibiotics are ineffective against colds, coughs, sore throats or the flu.


The new study echoes one released by the World Health Organization in November showing a widespread misunderstanding of what antibiotics can effectively treat, as well as why doctors should be careful how often they prescribe antibiotics and what for.

"These findings suggest that practices that try to help prevent the spread of antibiotic-resistant bacteria by prescribing fewer antibiotics are likely to experience a drop in their satisfaction ratings," said Dr. Mark Ashworth, a researcher at King's College London, in a press release. "Although small-scale studies have shown that dissatisfaction about not receiving an antibiotic can be offset if the patient feels that they have been listened to or carefully examined, further research is needed to determine if this will help in the real world of busy GP practices."


In the study conducted at King's College, which is published in the British Journal of General Practice, researchers analyzed data collected in 2012 from just over 1 million responses to the General Practice Patient Survey, information on 8,164 general practice doctor's offices from the Quality and Outcomes Framework between 2011 and 2012, and general practice and demographic characteristics from the National Health Service in England.

Researchers found that 33.7 million prescriptions for antibiotics were given to the registered population of 53.8 million patients, and was the strongest predictor of overall doctor satisfaction out of 13 prescribing variables. For every 25 percent fewer antibiotic prescriptions given by an office, the offices experienced a 3- to 6-percentile point drop in their national satisfaction ranking.

"GPs often feel pressured by patients to prescribe antibiotics and find it difficult to refuse a patient who asks for them," Ashworth said.

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Part of the problem, researchers said, is ignorance on the part of patients. The WHO study showed 64 percent of people studied thought antibiotics can be used to treat colds and flu, despite having no impact on viruses.

One-third of people in the WHO study also said they thought they should stop taking antibiotics when they "feel better," an action that is against doctors' instructions and which scientists say contributes to antibiotic resistance. More than three-quarters of respondents to the WHO study also said they thought the human body becomes resistant to antibiotics, rather than bacteria that infect humans resisting the drugs.


Researchers and doctors say better education of the public on the best use of antibiotics, and how and why doctors are attempting to reduce their use, is necessary to avoid new health crises arising from the overuse of antibiotics.

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"It is frustrating that GP practices that are working hard to reduce inappropriate antibiotics prescribing face falling patient satisfaction ratings," Dr. Tim Ballard of the Royal College of General Practitioners, told the BBC. "It truly is a case of being damned if we do and damned if we don't. Public perception needs to change -- our patients need to understand that when diseases become resistant to antibiotics, it means that antibiotics will cease to work and, as it stands, we don't have an alternative."

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