Stenlund Säde, Appelt Kirstin C, Ruby Matthew B, Smith Nick, Lishman Hannah, Patrick David M
BC Centre for Disease Control, Vancouver, BC V5Z 4R4, Canada.
School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Antibiotics (Basel). 2024 Jul 16;13(7):657. doi: 10.3390/antibiotics13070657.
Patients' expectations are a major contributor to the unnecessary prescribing of antibiotics, yet limited research has examined how physicians can calibrate these expectations. The studies we conducted tested how varying messages could impact patients' expectations for antibiotics and their experience of medical appointments. All the participants read a short scenario about an appointment for mild sinusitis symptoms, with the patient's expectation of antibiotics. In Study 1, the participants ( = 1069) were randomly assigned to read a positively framed, neutral, or negatively framed message regarding unnecessary antibiotics. In Study 2, the participants ( = 1073) read a message emphasizing either the societal or personal harms of unnecessary antibiotics, or a message without additional rationale. None of our pre-registered hypotheses were supported, but our exploratory analyses indicated that the societal message increased concern about antibiotic resistance. The participants who were more concerned about resistance were less likely to ask for antibiotics, more satisfied when the physician did not prescribe them, and more likely to recommend the physician to a friend. Discussing the consequences of the different courses of action did not appear to negatively impact physician-patient rapport. These studies demonstrate an inexpensive method with which to pre-test various messages about antibiotic consumption, and suggest that such messages are not negatively received by patients.
患者的期望是导致抗生素不必要处方的一个主要因素，但针对医生如何调整这些期望的研究却很有限。我们进行的研究测试了不同的信息如何影响患者对抗生素的期望以及他们就医预约的体验。所有参与者都阅读了一个关于轻度鼻窦炎症状就诊的简短场景，其中包含患者对抗生素的期望。在研究1中，参与者（n = 1069）被随机分配阅读一条关于不必要使用抗生素的正面框架、中性或负面框架的信息。在研究2中，参与者（n = 1073）阅读了一条强调不必要使用抗生素的社会危害或个人危害的信息，或者一条没有额外理由的信息。我们预先登记的假设均未得到支持，但我们的探索性分析表明，关于社会危害的信息增加了对抗生素耐药性的担忧。对抗生素耐药性更为担忧的参与者索要抗生素的可能性较小，当医生不开具抗生素时他们更满意，并且更有可能向朋友推荐这位医生。讨论不同治疗方案的后果似乎并未对医患关系产生负面影响。这些研究展示了一种低成本的方法，可用于预先测试关于抗生素使用的各种信息，并表明此类信息不会被患者负面接受。
