Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Municipal Public Health Service Rotterdam-Rijnmond, Schiedamsedijk 95, 3011 EN, Rotterdam, The Netherlands.
BMC Prim Care. 2022 May 2;23(1):100. doi: 10.1186/s12875-022-01706-x.
If healthcare professionals perceive that patients strongly expect to be prescribed antibiotics, inappropriate prescriptions may result. As it is unknown whether this happens more often with certain patient groups, we explored whether general practitioners (GPs) and pharmacists perceived such expectations when they provided antibiotics to immigrant patients.
Ten GPs and five pharmacists from Rotterdam, the Netherlands, were interviewed on the basis of a semi-structured topic guide. Atlas.ti software was then used to conduct a thematic analysis.
GPs felt that immigrant patients, especially those who had arrived recently, were more likely to expect to receive antibiotics than native Dutch patients. However, these expectations had decreased over the last years and did not always lead immigrants to exert pressure on them. Except for language barriers, the factors reported by GPs to influence their antibiotic prescribing behaviour were unrelated to patients' immigrant background. If there was a language barrier, GPs experienced greater diagnostic uncertainty and needed additional time to obtain and communicate correct information. To overcome language barriers, they often used point-of-care testing to convince patients that antibiotics were unnecessary. Although pharmacists rarely experienced problems dispensing antibiotics to immigrants, they and GPs both struggled to find effective ways of overcoming language barriers, and stressed the need for multi-language support materials.
While pharmacists rarely experience any problems providing antibiotics to immigrants, GPs regularly face language barriers with immigrant patients, which complicate the diagnostic process and communicating information in the limited available time. This sometimes leads antibiotics to be prescribed inappropriately.
如果医疗保健专业人员认为患者强烈期望开抗生素，那么可能会开出不适当的处方。由于尚不清楚这种情况是否更常见于某些患者群体，我们探讨了全科医生 (GP) 和药剂师在为移民患者开抗生素时是否会察觉到这种期望。
来自荷兰鹿特丹的 10 名全科医生和 5 名药剂师根据半结构化主题指南接受了采访。然后使用 Atlas.ti 软件对主题进行分析。
全科医生认为移民患者，尤其是最近抵达的移民患者，比荷兰本地患者更有可能期望获得抗生素。然而，这些期望在过去几年中有所减少，并不总是导致移民患者对他们施加压力。除了语言障碍外，全科医生报告的影响他们抗生素处方行为的因素与患者的移民背景无关。如果存在语言障碍，全科医生会感到更大的诊断不确定性，需要额外的时间来获取和传达正确的信息。为了克服语言障碍，他们经常使用即时检测来让患者相信抗生素是不必要的。尽管药剂师在向移民分发抗生素方面很少遇到问题，但他们和全科医生都难以找到克服语言障碍的有效方法，并强调需要多语言支持材料。
虽然药剂师在向移民提供抗生素方面很少遇到问题，但全科医生经常与移民患者面临语言障碍，这使诊断过程和在有限的可用时间内传达信息变得复杂，有时导致不适当的抗生素处方。
