Parent Expectations for Antibiotics, Physician-Parent Communication, and Satisfaction

TLDR

Further study is needed to determine how parents indirectly communicate their desire for antibiotics and what additional communication techniques physicians can use to resist overprescribing. This study explores how parents convey antibiotic expectations to pediatricians and examines whether physicians can explain the decision not to prescribe antibiotics while preserving visit satisfaction. Researchers conducted pre‑visit surveys, audiotaped encounters, and post‑visit surveys across two private pediatric practices, involving 10 physicians and 295 parents who attended acute care visits between October 1996 and March 1997. Only 1 % of parents made a direct antibiotic request, yet physicians perceived an expectation 34 % of the time; offering a contingency plan for future antibiotics significantly increased satisfaction scores (76 vs 58.9, P < .05), suggesting physicians should provide such plans when antibiotics are not clinically indicated.

Abstract

To explore how parents communicate their preferences for antibiotics to their child's physician and to examine whether physicians can communicate why antibiotics are not being prescribed in a way that maintains satisfaction with the visit.Previsit survey of parents, audiotaping of the study encounters, and a postvisit survey of parents and physicians.Two private pediatric practices.Ten physicians (response rate = 77%) and a consecutive sample of 295 eligible parents (response rate = 86%) who attended acute care visits for their children between October 1996 and March 1997.Physician-perceived pressure to prescribe antibiotics and parental visit-specific satisfaction.Fifty percent of parents expressed a previsit expectation for antibiotics. Among these parents, only 1% made a direct verbal request for them. Even when no direct requests for antibiotics were made, physicians still perceived an expectation for antibiotics 34% of the time. Among parents who did not receive expected antibiotics, those offered a contingency plan from the physician (i.e., the possibility of receiving antibiotics in the future if their child did not get better) had a higher mean satisfaction score than parents not receiving a contingency plan (76 vs. 58.9; P<.05).Physicians should consider providing a contingency plan to parents who expect antibiotics for their children when there is no clinical indication. Further study is needed to determine how parents indirectly communicate their desire for antibiotics and what additional communication techniques physicians can use to resist the overprescribing of antibiotics.