Mar 16, 2006

Antibiotic prescribing for acute cough: the effect of perceived patient demand

The British Journal of General Practice : the Journal of the Royal College of General Practitioners
Samuel CoenenPaul Van Royen

Abstract

GPs decide whether or not to prescribe antibiotics for acute cough. Apart from clinical signs and symptoms, non-medical reasons influence this decision as well. To obtain a valid estimate of the effect of perceived patient demand. Secondary analysis of cluster randomised controlled trial data. Eighty-five Flemish GPs. GPs completed a preprinted form with medical as well as non-medical information and their prescription for 20 consecutive adult patients consulting with acute cough in the periods February to April 2000 and 2001. The effect of perceived patient demand on antibiotic prescribing was estimated by performing alternating logistic regression analysis. A hierarchical backwards elimination procedure, described by Kleinbaum, was used. Seventy-two GPs participated, including 1448 patients eligible for analysis; 500 (34.5%) were prescribed an antibiotic and, according to the GP, 218 (15.1%) asked for an antibiotic. In cases of perceived patient demand antibiotics were prescribed significantly more often (odds ratio [OR] = 4.64, 95% confidence interval [CI] = 2.96 to 7.26). In the final model (n = 819; OR = 4.60, 2.59 to 8.17); Hosmer-Lemeshow goodness-of-fit P = 0.72), the effect of perceived patient demand for an antibiotic...Continue Reading

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Mentioned in this Paper

Prescribing Patterns, Physician
Lung
Antibiotic throat preparations
Coughing
Antifungal Antibiotics, Topical
Family Medicine (Field)
Acute Disease
Antibiotics, Gynecological
Upper Respiratory Infections
Lung Diseases

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