Significant change in patients' beliefs and expectations about antibiotic treatment for upper respiratory tract infection as the result of brief educational slideshows delivered immediately prior to general practice consultation

Abstract

Background: Many doctors state that they prescribe antibiotics for patients with URTIs because of patients’ beliefs and expectations. We designed two brief iPad© based slideshows to educate patients about the futility of antibiotic treatment for URTIs, and the substantial risk of adverse effects from antibiotic treatment. We evaluated the impact of these slideshows on the beliefs and expectations about antibiotic treatment, in patients presenting to their family doctor because of symptoms suggestive of an URTI. Materials/methods: Consenting patients who attended two urban general practices because of symptoms suggestive of an URTI, during three winter months in 2018, were randomly allocated to receive either of the two active slideshows, or a control slideshow (about the benefits of a healthy diet and exercise), while in the practice waiting room, immediately before their medical consultation. Before and after the slideshows, participants were asked to rate, on a Likert scale, their agreement with the statements: “I think antibiotics are helpful treatments for cold/flu” and “I wish to receive antibiotics for my cold/flu”. All antibiotics dispensed to study participants, during the week after the medical consultation, were identified using national dispensing records. Results: 325 patients participated in the study. There were highly significant reductions in the mean Likert scores for beliefs about antibiotic efficacy and expectations for an antibiotic prescription among participants who received the active presentations. (Figure) Conversely, there were no significant changes in the mean Likert scores for the control group. There were no differences between the three groups with regard to the proportion who were dispensed an antibiotic during the 7 days following the consultation (29% overall). Conclusions: Simple brief interventions can significantly change patients’ beliefs and expectations about antibiotic treatment, without any impact on prescriber behaviour. Interventions that target both the prescriber and the patient are more likely to change prescriber behaviour.