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Frugal antibiotic scripts linked to lower practice scores


General practices where nurses and doctors prescribe fewer antibiotics – in line with national policy – are viewed less satisfactorily by patients than others, according to a UK study.

The new study by King’s College London found reduced antibiotic prescribing was associated with lower patient satisfaction scores in the national General Practice Patient Survey, which is a component of the quality and out comes framework.

“Further research is needed to determine if this will help in the real world of busy GP practices”

Mark Ashworth

Researchers found a 25% lower rate of antibiotic prescribing by a practice corresponded to a five to six point reduction on GP satisfaction rankings.

The study, published in the British Journal of General Practice, analysed records from 7,800 general practices, 96% of which were in England.

After taking into account demographic and practice factors, antibiotic prescribing was a significant determinant of patient experience.

For example, for a practice that prescribed 25% fewer antibiotics than the national average, there was a corresponding reduction in the national GP satisfaction rankings from the 50th centile to the 44th to 45th centile.

Dr Mark Ashworth, lead author of the study from the King’s Division of Health and Social Care Research, said: “Many patients come in asking for antibiotics when they have viral infections such as colds, coughs, sore throats, or the ’flu, but antibiotics cannot treat viruses.

“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,” he said.

He added: “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.”

A previous study by Public Health England found 51% of patients were inappropriately prescribed an antibiotic for coughs and colds, for which antibiotics were completely ineffective.

The authors point out this study was observational, so no definitive conclusions can be drawn about cause and effect.

However, they said their findings were consistent with previous small-scale studies that found patients who did not receive antibiotics were much more likely to express dissatisfaction.


Readers' comments (3)

  • Pretty obvious conclusion, I would have thought. It just shows how unscientific and inappropriate patient satisfaction questionnaires are in determining the competence and quality of the healthcare that is being supplied.

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  • there needs to be far better general understanding of the use and abuse of antibiotics involving improved training for the professionals and far more effective education for the public to enable them to take greater responsibility for their own care. don't just prejudice the busy GPs and their professional colleagues!

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  • michael stone

    Patient Satisfaction is a useful measure. So are many other things.

    It strikes me that there are a few issues here, including:

    1) Have clinicians explained to all patients, that antibiotics will not cure viral infections ?

    2) If you have got a respiratory illness, has the GP proven to you, that the illness isn't bacterial ? Indeed, can the GP prove that the illness isn't bacterial ?

    3) Patients who 'turn up because they feel ill' might not be all that keen to hear 'I don't think I can do anything' from the GP.

    4) The old 'GPs don't like lengthy arguments with patients [so are sometimes tempted to hand over the tablets, to avoid that]' one.

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