Miroslav Sirota1, Thomas Round2, Shyamalee Samaranayaka3, Olga Kostopoulou4. 1. Department of Psychology. 2. Primary Care and Public Health Sciences, King's College London. 3. Department of Family Medicine, University of Sri Jayewardenepura. 4. Department of Surgery and Cancer, Imperial College London.
Abstract
OBJECTIVE: Clinically irrelevant but psychologically important factors such as patients' expectations for antibiotics encourage overprescribing. We aimed to (a) provide missing causal evidence of this effect, (b) identify whether the expectations distort the perceived probability of a bacterial infection either in a pre- or postdecisional distortions pathway, and (c) detect possible moderators of this effect. METHOD: Family physicians expressed their willingness to prescribe antibiotics (Experiment 1, n₁ = 305) or their decision to prescribe (Experiment 2, n₂ = 131) and assessed the probability of a bacterial infection in hypothetical patients with infections either with low or high expectations for antibiotics. Response order of prescribing/probability was manipulated in Experiment 1. RESULTS: Overall, the expectations for antibiotics increased intention to prescribe (Experiment 1, F(1, 301) = 25.32, p < .001, ηp² = .08, regardless of the response order; Experiment 2, odds ratio [OR] = 2.31, and OR = 0.75, Vignettes 1 and 2, respectively). Expectations for antibiotics did not change the perceived probability of a bacterial infection (Experiment 1, F(1, 301) = 1.86, p = .173, ηp² = .01, regardless of the response order; Experiment 2, d = -0.03, and d = +0.25, Vignettes 1 and 2, respectively). Physicians' experience was positively associated with prescribing, but it did not moderate the expectations effect on prescribing. CONCLUSIONS: Patients' and their parents' expectations increase antibiotics prescribing, but their effect is localized-it does not leak into the perceived probability of a bacterial infection. Interventions reducing the overprescribing of antibiotics should target also psychological factors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
RCT Entities:
OBJECTIVE: Clinically irrelevant but psychologically important factors such as patients' expectations for antibiotics encourage overprescribing. We aimed to (a) provide missing causal evidence of this effect, (b) identify whether the expectations distort the perceived probability of a bacterial infection either in a pre- or postdecisional distortions pathway, and (c) detect possible moderators of this effect. METHOD: Family physicians expressed their willingness to prescribe antibiotics (Experiment 1, n₁ = 305) or their decision to prescribe (Experiment 2, n₂ = 131) and assessed the probability of a bacterial infection in hypotheticalpatients with infections either with low or high expectations for antibiotics. Response order of prescribing/probability was manipulated in Experiment 1. RESULTS: Overall, the expectations for antibiotics increased intention to prescribe (Experiment 1, F(1, 301) = 25.32, p < .001, ηp² = .08, regardless of the response order; Experiment 2, odds ratio [OR] = 2.31, and OR = 0.75, Vignettes 1 and 2, respectively). Expectations for antibiotics did not change the perceived probability of a bacterial infection (Experiment 1, F(1, 301) = 1.86, p = .173, ηp² = .01, regardless of the response order; Experiment 2, d = -0.03, and d = +0.25, Vignettes 1 and 2, respectively). Physicians' experience was positively associated with prescribing, but it did not moderate the expectations effect on prescribing. CONCLUSIONS:Patients' and their parents' expectations increase antibiotics prescribing, but their effect is localized-it does not leak into the perceived probability of a bacterial infection. Interventions reducing the overprescribing of antibiotics should target also psychological factors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Authors: David A Broniatowski; Eili Y Klein; Larissa May; Elena M Martinez; Chelsea Ware; Valerie F Reyna Journal: Med Decis Making Date: 2018-07 Impact factor: 2.583
Authors: Janelle M Fouhse; Kaiyuan Yang; Juan More-Bayona; Yanhua Gao; Susan Goruk; Graham Plastow; Catherine J Field; Daniel R Barreda; Benjamin P Willing Journal: Front Immunol Date: 2019-09-04 Impact factor: 7.561
Authors: Diane Ashiru-Oredope; Anne Doble; Tracey Thornley; Ayoub Saei; Natalie Gold; Anna Sallis; Cliodna A M McNulty; Donna Lecky; Eno Umoh; Chaamala Klinger Journal: Pharmacy (Basel) Date: 2020-03-19
Authors: Traci D Yates; Marion E Davis; Yhenneko J Taylor; Lisa Davidson; Crystal D Connor; Katherine Buehler; Melanie D Spencer Journal: BMC Fam Pract Date: 2018-06-23 Impact factor: 2.497