Stenlund Säde, Mâsse Louise C, Stenlund David, Sillanmäki Lauri, Appelt Kirstin C, Koivumaa-Honkanen Heli, Rautava Päivi, Suominen Sakari, Patrick David M
School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
BC Centre for Disease Control, Vancouver, BC V5Z 4R4, Canada.
Antibiotics (Basel). 2023 Jun 7;12(6):1022. doi: 10.3390/antibiotics12061022.
Previous research suggests that the characteristics of both patients and physicians can contribute to the overuse of antibiotics. Until now, patients' psychosocial characteristics have not been widely explored as a potential contributor to the overuse of antibiotics. In this study, the relationship between a patient's psychosocial characteristics (self-reported in postal surveys in 2003) and the number of antibiotics they were prescribed (recorded in Finnish national registry data between 2004-2006) were analyzed for 19,300 working-aged Finns. Psychosocial characteristics included life satisfaction, a sense of coherence, perceived stress, hostility, and optimism. In a structural equation model, patients' adverse psychosocial characteristics were not related to increased antibiotic prescriptions in the subsequent three years. However, these characteristics were strongly associated with poor general health status, which in turn was associated with an increased number of subsequent antibiotic prescriptions. Furthermore, mediation analysis showed that individuals who used healthcare services more frequently also received more antibiotic prescriptions. The current study does not support the view that patients' adverse psychosocial characteristics are related to an increased number of antibiotic prescriptions. This could encourage physicians to actively discuss treatment options with their patients.
先前的研究表明，患者和医生的特征都可能导致抗生素的过度使用。到目前为止，患者的心理社会特征作为抗生素过度使用的一个潜在因素尚未得到广泛探讨。在这项研究中，对19300名工作年龄的芬兰人分析了其心理社会特征（2003年通过邮政调查自我报告）与他们所开具的抗生素数量（记录在2004 - 2006年芬兰国家登记数据中）之间的关系。心理社会特征包括生活满意度、连贯感、感知压力、敌意和乐观情绪。在一个结构方程模型中，患者不良的心理社会特征与随后三年抗生素处方的增加无关。然而，这些特征与总体健康状况不佳密切相关，而总体健康状况不佳又与随后抗生素处方数量的增加有关。此外，中介分析表明，更频繁使用医疗服务的个体也会收到更多的抗生素处方。当前的研究不支持患者不良的心理社会特征与抗生素处方数量增加有关的观点。这可能会鼓励医生与患者积极讨论治疗方案。
