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      Antibiotic prescribing and patient satisfaction in primary care in England: cross-sectional analysis of national patient survey data and prescribing data

      research-article
      , DM, MRCP, FRCGP , MRCP, FRCGP, MD , MSc, MPH , PhD , MSc, PhD, FRCGP, FFPH
      The British Journal of General Practice
      Royal College of General Practitioners
      antibiotic prescribing, antibiotics, patient experience, patient satisfaction, primary health care

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          Abstract

          Background

          Concerns about adverse effects on patient satisfaction may be an important obstacle to attempts to curtail antibiotic prescribing.

          Aim

          To determine the relationship between antibiotic prescribing in general practice and reported patient satisfaction.

          Design and setting

          Retrospective cross-sectional study of general practices in England.

          Method

          Data were obtained from the General Practice Patient Survey (GPPS) in 2012 (2.7 million questionnaires in England; 982 999 responses; response rate 36%); the national Quality and Outcomes Framework dataset for England, 2011–2012 (8164 general practices); and general practice and demographic characteristics. Standardised measures of antibiotic prescribing volumes were obtained for each practice in England during 2012–2013, together with 12 other nationally available prescribing variables. The role of antibiotic prescribing volume was identified as a determinant of GPPS scores and adjusted for demographic and practice factors using multiple linear regression.

          Results

          The final dataset consisted of 7800 (95.5%) practices. A total of 33.7 million antibiotic prescriptions were issued to a registered population of 53.8 million patients. Antibiotic prescribing volume was a significant positive predictor of all ‘doctor satisfaction’ and ‘practice satisfaction’ scores in the GPPS, and was the strongest predictor of overall satisfaction out of 13 prescribing variables. A theoretical 25% reduction in antibiotic prescribing volume would be associated with 0.5–1.0% lower patient satisfaction scores, a drop of 3–6 centile points in national satisfaction ranking.

          Conclusion

          Patients were less satisfied in practices with frugal antibiotic prescribing. A cautious approach to antibiotic prescribing may require a trade-off in terms of patient satisfaction.

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          Author and article information

          Contributors
          Role: Reader in primary care
          Role: Clinical senior lecturer
          Role: Student
          Role: Research fellow
          Role: Professor of medicine and sociology
          Journal
          Br J Gen Pract
          Br J Gen Pract
          bjgp
          The British Journal of General Practice
          Royal College of General Practitioners
          0960-1643
          1478-5242
          January 2016
          07 December 2015
          : 66
          : 642
          : e40-e46
          Affiliations
          Department of Primary Care and Public Health Sciences, King’s College London, UK.
          Department of Primary Care and Public Health Sciences, King’s College London, UK.
          Department of Primary Care and Public Health Sciences, King’s College London, UK.
          Department of Primary Care and Public Health Sciences, King’s College London, UK.
          Department of Primary Care and Public Health Sciences, King’s College London, UK.
          Author notes
          Address for correspondence Mark Ashworth, Department of Primary Care and Public Health Sciences, King’s College London School of Medicine, Guy’s Campus, London SE1 1UL, UK. E-mail: mark.ashworth@ 123456kcl.ac.uk
          Article
          PMC4684034 PMC4684034 4684034
          10.3399/bjgp15X688105
          4684034
          26639947
          7822dc64-10ec-43dd-93cc-2d200ceb94fc
          © British Journal of General Practice 2016
          History
          : 02 March 2015
          : 24 March 2015
          : 05 June 2015
          Categories
          Research

          primary health care,antibiotic prescribing,antibiotics,patient experience,patient satisfaction

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