Wollny Anja, Altiner Attila, Garbe Katharina, Klingenberg Anja, Kaufmann-Kolle Petra, Köppen Martina, Kamradt Martina, Poß-Doering Regina, Wensing Michel, Leyh Mirko, Voss Arwed, Feldmeier Gregor
Institut für Allgemeinmedizin, Universitätsmedizin Rostock.
Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg.
Dtsch Med Wochenschr. 2022 Sep;147(18):e82-e90. doi: 10.1055/a-1871-7626. Epub 2022 Aug 16.
The use of antibiotics in human medicine is partly responsible for the global increase in antibiotic resistance. Significant reductions in antibiotic prescribing were realised through educational campaigns, communication training and prescribing feedback. Based on data from the cluster-randomised CHANGE-3 trial, the present analysis focuses on the question of patient expectations for an antibiotic in acute respiratory infections.
106 of 114 General Practitioner (GP) practices in Baden-Württemberg and Mecklenburg-Western Pomerania took part in the study. 4736 patients who visited the practices with acute respiratory infections from October 2018 to May 2019 filled out a questionnaire after the doctor's consultation. The analysis was descriptive.
16.7 % of patients with acute respiratory infections reported receiving antibiotics from their GP. 13.3 % of patients had hoped for an antibiotic and 5.5 % stated that they had asked their GP for an antibiotic prescription. The lowest prescription rate for antibiotics was reported by patients who had received a diagnosis of influenza from their GP. With specific diagnoses differentiated from uncomplicated respiratory tract infection, an increase in both the number of antibiotics hoped for and the number of antibiotics prescribed was observed.
Patients still receive antibiotics more often than they actually hope for. On the part of GPs, prescriptions may still be written because of perceived pressure from patients, but this is not reflected in patient expectations. In addition to dealing openly with patients' expectations, strengthening patients' health literacy, mindful doctor-patient communication and offered opportunities for re-presentation in the case of specific diagnoses could further reduce the perceived pressure on GPs.
人类医学中抗生素的使用在一定程度上导致了全球抗生素耐药性的增加。通过开展教育活动、进行沟通培训以及提供处方反馈，抗生素的处方量有了显著减少。基于整群随机分组的CHANGE - 3试验数据，本分析聚焦于急性呼吸道感染患者对抗生素的期望问题。
巴登 - 符腾堡州和梅克伦堡 - 前波美拉尼亚州的114家全科医生（GP）诊所中有106家参与了该研究。2018年10月至2019年5月期间因急性呼吸道感染到这些诊所就诊的4736名患者在医生问诊后填写了一份问卷。分析采用描述性方法。
16.7%的急性呼吸道感染患者报告从其全科医生处接受了抗生素治疗。13.3%的患者希望得到抗生素治疗，5.5%的患者表示他们曾向全科医生索要抗生素处方。从全科医生处获得流感诊断的患者报告的抗生素处方率最低。与单纯呼吸道感染区分开来的特定诊断中，希望得到抗生素治疗的患者数量和实际开具抗生素处方的数量均有所增加。
患者实际接受抗生素治疗的频率仍高于他们的期望。对于全科医生而言，开具处方可能仍是因为感觉到来自患者的压力，但这并未反映在患者的期望中。除了公开应对患者的期望外，提高患者的健康素养、注重医患沟通以及在特定诊断情况下提供复诊机会，可能会进一步减轻全科医生所感受到的压力。
