Blog | Tuesday, March 25, 2014

QD: News Every Day--Try an indirect approach for inappropriate antibiotics

While experts suggest that doctors directly ask patients whether they expect to receive antibiotics for upper respiratory infections, family physicians in the UK reported success by avoiding confrontations and instead eliciting expectations in an indirect manner before performing a physical examination, a study found.

A researcher conducted in-person interviews with 20 family physicians in South Wales, and outcomes from the semi-structured interviews appeared in the Annals of Family Medicine.

The doctors reported not directly asking their patients about expecting to receive antibiotics, because it sets up a confrontation with the patient. They reported instead eliciting patient or parent expectations by asking questions such as “Is there anything specific you wanted from me today?”

They also asked their questions before the physical exam, because the findings might help them dissuade the patient, for example, in those who may not have a high temperatures or may have clear tonsils.

“As clinicians are more likely to adhere to clinical recommendations that are compatible with their values, our model derived from empirical data may influence acceptance of evidence-based prescribing decisions that may be counter to patient or parent expectations,” the authors wrote. “Moreover, if this goal can be accomplished within the confines of 10-minute consultations, that will enhance its acceptance and application as an intervention by family physicians who may be seeking to adopt a different approach to a challenging consultation.”