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Non-pharmalogical drivers of antibiotic prescription in primary care (Japan, United Kingdom, United States)

Case study | |

Primary care physicians are under increasing pressure to improve patient satisfaction and protect performance ratings. This reflects a shift in contemporary health care systems towards consumerist models. In Japan, the United Kingdom and the United States, physicians report prescribing antibiotics to protect against the perceived risk of reputational damage and legal reprisal. In some cases, physicians feel pressured into prescribing antibiotics by their patients.  

In low-income countries, sociocultural factors shaping antibiotic prescription include high patient–doctor ratios which prohibit thorough discussion of patient symptoms. It has also been reported that lack of privacy in clinical settings may encourage doctors to prescribe antibiotics for some suspected conditions, such as gonorrhoea, without medical examination.  

Cultural norms and expectations also affect the implementation of interventions designed to reduce antibiotic use. In the United Kingdom, GPs are turning towards C-Reactive Protein diagnostic tests as a defensive practice to convince patients that they do not need an antibiotic prescription. However, the same research found that patients would have been happy with a no-antibiotic decision if they had been given a full explanation. What they required was an engagement with their doctor that did not need to involve a medical procedure or prescription. Related research has cautioned against the use of diagnostic tests due to potential false results and their impact on limited health care resources. 

 

 

Photo by Roberto Sorin on Unsplash

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