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. 2023 Jun 7;12(6):1022.
doi: 10.3390/antibiotics12061022.

Do Patients' Psychosocial Characteristics Impact Antibiotic Prescription Rates?

Säde Stenlund  1   2   3   4 , Louise C Mâsse  1   5 , David Stenlund  6   7 , Lauri Sillanmäki  3   4   8 , Kirstin C Appelt  9 , Heli Koivumaa-Honkanen  10 , Päivi Rautava  3   4 , Sakari Suominen  3   4   11 , David M Patrick  1   2
Affiliations

Do Patients' Psychosocial Characteristics Impact Antibiotic Prescription Rates?

Säde Stenlund et al. Antibiotics (Basel). .

Abstract

Previous research suggests that the characteristics of both patients and physicians can contribute to the overuse of antibiotics. Until now, patients' psychosocial characteristics have not been widely explored as a potential contributor to the overuse of antibiotics. In this study, the relationship between a patient's psychosocial characteristics (self-reported in postal surveys in 2003) and the number of antibiotics they were prescribed (recorded in Finnish national registry data between 2004-2006) were analyzed for 19,300 working-aged Finns. Psychosocial characteristics included life satisfaction, a sense of coherence, perceived stress, hostility, and optimism. In a structural equation model, patients' adverse psychosocial characteristics were not related to increased antibiotic prescriptions in the subsequent three years. However, these characteristics were strongly associated with poor general health status, which in turn was associated with an increased number of subsequent antibiotic prescriptions. Furthermore, mediation analysis showed that individuals who used healthcare services more frequently also received more antibiotic prescriptions. The current study does not support the view that patients' adverse psychosocial characteristics are related to an increased number of antibiotic prescriptions. This could encourage physicians to actively discuss treatment options with their patients.

Keywords: antibiotic consumption; antibiotic prescribing; antimicrobial stewardship; excess antibiotic use; psychosocial; structural equation modeling.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flow chart of the study population.
Figure 2
Figure 2
The association between health status, psychosocial factors, and the subsequent frequency of antibiotic prescription. The numbers and relative line widths indicate the effect sizes of the pathways in the structural equation model.
Figure 3
Figure 3
The association between health status, psychosocial factors, and the subsequent frequency of antibiotic prescription with the mediation by a tendency to use healthcare. The indirect pathway from health status to prescription of antibiotics was significant (β = 0.073, p < 0.001). The numbers and relative line widths indicate the effect sizes of the pathways in the structural equation model.
See this image and copyright information in PMC

References

    1. WHO Ten Threats to Global Health in 2019. [(accessed on 28 March 2023)]. Available online: https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-....
    1. Murray C.J., Ikuta K.S., Sharara F., Swetschinski L., Robles Aguilar G., Gray A., Han C., Bisignano C., Rao P., Wool E., et al. Global Burden of Bacterial Antimicrobial Resistance in 2019: A Systematic Analysis. Lancet. 2022;399:629–655. doi: 10.1016/S0140-6736(21)02724-0. - DOI - PMC - PubMed
    1. King L.C.M., Fleming-Dutra K.E., Hicks L.A. Advances in Optimizing the Prescription of Antibiotics in Outpatient Settings. BMJ. 2018;363:k3047. doi: 10.1136/bmj.k3047. - DOI - PMC - PubMed
    1. Van Der Zande M.M., Dembinsky M., Aresi G., Van Staa T.P. General Practitioners’ Accounts of Negotiating Antibiotic Prescribing Decisions with Patients: A Qualitative Study on What Influences Antibiotic Prescribing in Low, Medium and High Prescribing Practices. BMC Fam. Pract. 2019;20:172. doi: 10.1186/s12875-019-1065-x. - DOI - PMC - PubMed
    1. Macfarlane J., Holmes W., Macfarlane R., Britten N. Influence of Patients’ Expectations on Antibiotic Management of Acute Lower Respiratory Tract Illness in General Practice: Questionnaire Study. Br. Med. J. 1997;315:1211–1214. doi: 10.1136/bmj.315.7117.1211. - DOI - PMC - PubMed

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