Antibiotic Rx: No Substitute for Time Spent with Patient
October 14, 2005
Gone are the days when a visit to your doctor included a lengthy chat. Visits are often as short as possible, with doctors wanting to maximize their patient numbers and thus their incomes. But does replacing doctor-patient discussion time with a hastily written prescription affect patient satisfaction?
It does, according to Researchers at the Centers for Disease Control, who recently found that patients who received an antibiotic prescription for acute respiratory tract infection (URI) found it to be "an unsatisfactory substitute for spending time with the patient, explaining the condition and treatment."
The study data were presented at the Infectious Disease Society of America Meeting 2005 and reported by MedPage Today on 12 October.
Results of Data Review
To test the notion people with URIs require a prescription to feel adequately cared for, Alexandra Newman, DVM, MPH, and colleagues at the CDC reviewed pharmacy records and corresponding patient-satisfaction surveys from a clinic's in-house pharmacy, according to MedPage Today.
Newman and colleagues reviewed a total of 1,404 surveys sent out by the Marshfield Clinic (a regional HMO in Marshfield, Wisconsin) between 1999 and 2003. All patients whose records were included in the study had sought care from a primary-care doctor to treat a URI, according to the CDC team. Among the patient group studied, 217 adults (45% of 486) and 408 children (49% of 918) received antibiotics. Nearly half (46%) the adults and one-third (31%) of the children received non-bacterial diagnoses.
A review of data revealed no correlation between treatment satisfaction and receiving an antibiotic prescription among either parents of children who received treatment or the adults who received treatment. Additionally, the likelihood of participants in either group giving their treatment an "excellent" rating in the survey did not increase with receipt of an antibiotic prescription.
In contrast, the physicians' spending time with the patient and explaining what he/she thought was going on and what they planned to do about it, as well as the physician's personal manner, were positively associated with an "excellent" rating among both groups.
Dr. Newman noted that the surveys' low response rate (31%) may have introduced a selection bias in the study sample, and added, "We have to work with the tools available," according to MedPage Today.
Moreover, cross-checking the pharmacy data with chart information revealed that a significant number of antibiotic prescriptions were not captured in the original analysis. These prescriptions may have been filled outside the HMO system, may not have been filled at all, or the patients may have received samples, according to the study researchers.
Sources:
IDSA:
A Scribbled Antibiotic Prescription Can't Buy Patient
Satisfaction, MedPage Today, 12 October 2005.
Newman, A. Patient Satisfaction and Antibiotic Use for Acute Upper
Respiratory Tract Infections, Infectious Disease Society of America
Meeting 2005, Abstract #124.
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