Understanding determinants of patients’ decisions to attend their family physician and to take antibiotics for upper respiratory tract infections: a qualitative descriptive study

Abstract

Background: Although antibiotics have little or no benefit for most upper respiratory tract infections (URTIs), they continue to be prescribed frequently in primary care. Physicians perceive that patients' expectations influence their antibiotic prescribing practice; however, not all patients seek antibiotic treatment despite having similar symptoms. In this study, we explored patients' views about URTIs, and the ways patients manage them (including attendance in primary care and taking antibiotics). Methods: Using a qualitative descriptive design, adult English-speaking individuals at a Canadian health center were recruited through convenient sampling. The participants were interviewed using semi-structured interview guide based on the Common Sense-Self-Regulation Model (CS-SRM). The interviews were transcribed verbatim and coded according to CS-SRM dimensions (illness representations, coping strategies). Sampling continued until thematic saturation was achieved. Thematic analysis related to the dimensions of CS-SRM was applied. Results: Generally, participants had accurate perception about the symptoms of URTIs, as well as how to prevent and manage them. However, some participants revealed misconceptions about the causes of URTIs. Almost all participants mentioned that they only visited their doctor if their symptoms got progressively worse and they could no longer self-manage the symptoms. When visiting a doctor, most participants reported that they did not seek antibiotics. They expected to receive an examination and an explanation for their symptoms.

Clinician and Patient Factors Influencing Treatment Decisions: Ethnographic Study of Antibiotic Prescribing and Operative Procedures in Out-of-Hours and General Dental Practices

“…Our ethnographic study confirmed 'antibiotic beliefs' as influencing dentists too and identified it as a patient factor also. Interestingly, our study and another about antibiotics for upper respiratory tract infections [30] found that patients reported a good understanding the risks (and lack of benefits) of antibiotics, they still wanted them. The Wellcome Trust has also recognized the significance of patient beliefs about antibiotic risks and has recommended introducing a sense of personal jeopardy to messaging [31].…”

Antibiotic Prescribing and Doctor-Patient Communication During Consultations for Respiratory Tract Infections: A Video Observation Study in Out-of-Hours Primary Care

“…Also, the need for assessment, information, or reassurance rather than expectations for antibiotics, are possible reasons to consult (33)(34)(35). Most expect a thorough examination and explanation for their symptoms (36). Soliciting patient expectations could lead to higher patient satisfaction and reduced antibiotic prescribing (37)(38)(39).…”

Autonomy, power dynamics and antibiotic use in primary healthcare: A qualitative study

“…Recent qualitative research on this area has explored service users' [32] and prescribers' [33][34][35][36][37] attitudes towards delayed antibiotic prescription, prescribers' attitudes and experiences on antibiotic prescribing [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54], service users' experiences on antibiotic use [38,39,48,51,[55][56][57][58], self-care treatments for ALRTIs [32,59], service users' [48,60] and health professionals' [47,48] understandings of AMR and antibiotic use, interactions between health Committee of the Institut de Recerca en Atenció Primària Jordi Gol i Gurina (IDIAPJGol) (contact via cei@idiapjgol.info) for researchers who meet the criteria for access to confidential data. For more information on data availability restrictions you can contact the ethics committee at cei@idiapjgol.info.…”

“…Recent qualitative research on this area has explored service users’ [ 32 ] and prescribers’ [ 33 – 37 ] attitudes towards delayed antibiotic prescription, prescribers’ attitudes and experiences on antibiotic prescribing [ 38 – 54 ], service users’ experiences on antibiotic use [ 38 , 39 , 48 , 51 , 55 – 58 ], self-care treatments for ALRTIs [ 32 , 59 ], service users’ [ 48 , 60 ] and health professionals’ [ 47 , 48 ] understandings of AMR and antibiotic use, interactions between health professionals and service users [ 47 ], experiences of ALRTIs [ 59 ], the role of pharmaceutical companies on antibiotic overprescribing and AMR [ 39 ], and socio-cultural factors to promote adequate antibiotic use [ 61 ]. These studies are mostly focused on health professionals’ experiences (rather than service users’) and take a conventional biomedical perspective to health and AMR.…”