Schwartz Malaika, Hardy Victoria, Keppel Gina A, Alto William, Hornecker Jaime, Robitaille Beth, Neher Jon, Holmes John, Dirac M Ashworth, Cole Allison M, Thompson Matthew
From the Department of Family Medicine, University of Washington, Seattle (MS, VH, GAK, AMC, MT); the Seattle Indian Health Board, Seattle, WA (WA); the University of Wyoming Family Medicine Residency, Casper (JH, BR); Valley Family Medicine, Renton (JN); the Department of Family Medicine, Idaho State University, Pocatello (JH); the Swedish First Hill Family Medicine Residency Clinic, Seattle (MAD); the Harborview Medical Center, Seattle (AMC); and the Institute of Translational Health Sciences, Seattle (AMC).
J Am Board Fam Med. 2017 Sep-Oct;30(5):645-656. doi: 10.3122/jabfm.2017.05.170087.
The majority of consultations for acute respiratory tract infections (RTIs) lead to prescriptions for antibiotics, which have limited clinical benefit. We explored patients' willingness to have blood tests as part of the diagnostic work-up for RTIs, and patient knowledge about antibiotics.
Patients at 6 family medicine clinics were surveyed. Regression modeling was used to determine independent predictors of willingness to have venous and point-of-care (POC) blood tests, and knowledge of the value of antibiotics for RTIs.
Data were collected from 737 respondents (response rate 83.8%), of whom 65.7% were women, 60.1% were white, and 25.1% were current smokers; patients' mean age was 46.9 years. Sex (female), race (white), and a preference to avoid antibiotics were independent predictors of greater level of antibiotic knowledge. A total of 63.1% were willing to have a venous draw and 79% a POC blood test, to help guide antibiotic decision-making. Non-American Indian/Alaskan Native race, current smoking, and greater knowledge of antibiotics were independent predictors of willingness to have a POC test.
A large majority of patients seemed willing to have POC tests to facilitate antibiotic prescribing decisions for RTIs. Poor knowledge about antibiotics suggests better education regarding antibiotic use might influence patient attitudes towards use of antibiotics for RTIs.
大多数因急性呼吸道感染(RTIs)进行的会诊都会开出抗生素处方,但其临床益处有限。我们探讨了患者作为RTIs诊断检查一部分进行血液检查的意愿,以及患者对抗生素的了解情况。
对6家家庭医学诊所的患者进行了调查。采用回归模型确定愿意接受静脉血和即时检验(POC)血液检查的独立预测因素,以及对抗生素治疗RTIs价值的了解情况。
共收集了737名受访者的数据(回复率83.8%),其中65.7%为女性,60.1%为白人,25.1%为当前吸烟者;患者的平均年龄为46.9岁。性别(女性)、种族(白人)以及避免使用抗生素的偏好是抗生素知识水平较高的独立预测因素。共有63.1%的人愿意接受静脉采血,79%的人愿意接受POC血液检查,以帮助指导抗生素决策。非美洲印第安人/阿拉斯加原住民种族、当前吸烟以及对抗生素的更多了解是愿意接受POC检查的独立预测因素。
绝大多数患者似乎愿意接受POC检查,以促进RTIs抗生素处方决策。对抗生素的了解不足表明,更好地开展抗生素使用教育可能会影响患者对RTIs使用抗生素的态度。