Weighing patient attributes in antibiotic prescribing for upper respiratory tract infections

A discrete choice experiment on primary care physicians in Hubei Province, China

Bibliographic Data

ID22086722
AuthorsTianqin Xue (Hubei University of Education), Chaojie Liu (0000-0003-0877-0424, La Trobe University), Zhuoxian Li (Shanghai University of Traditional Chinese Medicine), Junjie Liu (0009-0002-6907-3470, Central University of Finance and Economics), Yuqing Tang (0000-0003-4483-2688, Hubei University of Education, corresponding author)
Year2022
Volume10
Pages1008217-1008217
Publication date2022-12-20
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2022.1008217
PMID36605239
OpenAlexW4313432472
LanguageEN
Citations received1
References cited60

Objectives This study aimed to determine how primary care physicians weigh intervenable patient attributes in their decisions of antibiotic prescribing for upper respiratory tract infections (URTIs). Methods A discrete choice experiment (DCE) was conducted on 386 primary care physicians selected through a stratified cluster sampling strategy in Hubei province, China. The patient attributes tested in the DCE were identified through semi-structured interviews with 13 primary care physicians, while the choice scenarios were determined by a D-efficient design with a zero prior parameter value. Conditional logit models (CL) and mixed logit models (MXL) were established to determine the preference of the study participants in antibiotic prescribing for URTI patients with various attributes. Relative importance (RI) was calculated to reflect the influence of each attribute. Results In addition to age and duration of symptoms, the interventionable patient attributes were also considered by the primary care physicians in their antibiotic prescribing decisions. They preferred to prescribe antibiotics for URTI patients with difficulties to schedule a follow-up appointment ( p < 0.001) and for those without a clear indication of refusal to antibiotics ( p < 0.001). Patient request for antibiotics had an RI ranging from 15.2 to 16.3%, compared with 5.1–5.4% for easiness of follow-up appointment. The influence of these two interventionable patient attributes was most profound in the antibiotic prescribing decisions for patients aged between 60 and 75 years as indicated by their interaction effects with age (β = 0.69 for request for antibiotics, p < 0.01; β = −1.2 for easiness of follow-up, p < 0.001). Conclusion Reducing patient pressure and improving accessibility and continuity of care may help primary care physicians make rational antibiotic prescribing decisions for URTIs

Antibiotics · China · Environmental health · Family medicine · Geography · Intensive care medicine · Population · Primary care · Primary health care · Respiratory system · Respiratory tract infections · Upper respiratory infections · Upper respiratory tract infection · Antibiotic Use and Resistance · Economic and Environmental Valuation · Medicine · Patient Satisfaction in Healthcare · Internal Medicine

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