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

ObjectivesTo explore the causes of the gender gap in antibiotic prescribing, and to determine whether women are more likely than men to receive an antibiotic prescription per consultation.DesignCross-sectional analysis of routinely collected electronic medical records from The Health Improvement Network (THIN).SettingEnglish primary care.ParticipantsPatients who consulted general practices registered with THIN between 2013 and 2015.Primary and secondary outcome measuresTotal antibiotic prescribing was measured in children (<19 years), adults (19–64 years) and the elderly (65+ years). For 12 common conditions, the number of adult consultations was measured, and the relative risk (RR) of being prescribed antibiotics when consulting as female or with comorbidity was estimated.ResultsAmong 4.57 million antibiotic prescriptions observed in the data, female patients received 67% more prescriptions than male patients, and 43% more when excluding antibiotics used to treat urinary tract infection (UTI). These gaps were more pronounced in adult women (99% more prescriptions than men; 69% more when excluding UTI) than in children (9%; 0%) or the elderly (67%; 38%). Among adults, women accounted for 64% of consultations (62% among patients with comorbidity), but were not substantially more likely than men to receive an antibiotic prescription when consulting with common conditions such as cough (RR 1.01; 95% CI 1.00 to 1.02), sore throat (RR 1.01, 95% CI 1.00 to 1.01) and lower respiratory tract infection (RR 1.00, 95% CI 1.00 to 1.01). Exceptions were skin conditions: women were less likely to be prescribed antibiotics when consulting with acne (RR 0.67, 95% CI 0.66 to 0.69) or impetigo (RR 0.85, 95% CI 0.81 to 0.88).ConclusionsThe gender gap in antibiotic prescribing can largely be explained by consultation behaviour. Although in most cases adult men and women are equally likely to be prescribed an antibiotic when consulting primary care, it is unclear whether or not they are equally indicated for antibiotic therapy.

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Patient satisfaction and provider use of electronic communication: A cross-sectional analysis

European Journal for Person Centered Healthcare ◽

10.5750/ejpch.v5i4.1352 ◽

2017 ◽

Vol 5 (4) ◽

pp. 441 ◽

Cited By ~ 2

Author(s):

Joy L Lee ◽

Sydney M. Dy ◽

Steven J. Kravet ◽

Bimal H. Ashar ◽

Todd Nesson ◽

...

Keyword(s):

Primary Care ◽

Patient Satisfaction ◽

Text Messaging ◽

Primary Care Providers ◽

Care Providers ◽

Cross Sectional ◽

Communication Behaviors ◽

Cross Sectional Analysis ◽

Sectional Analysis ◽

The Relationship

Background: The way patients and providers communicate with one another outside of the clinic is changing. However, little is known about primary care provider perspectives and experiences of these changes and whether these provider behaviors correlate with patient satisfaction. This study examines provider patterns of communication with patients outside of the clinic setting via cellphone, email and text messaging and the relationship between communication behaviors and patient satisfaction. Method: Cross-sectional analysis of the association between patient satisfaction scores and a 16-question community survey of 149 Mid-Atlantic primary care providers in community practice was conducted in the year prior to clinic implementation of a new electronic health record system with secure patient-messaging capabilities.Results: Providers who gave patients their email addresses were more likely to communicate with their patients electronically than those who did not. Providers who made their email addresses available to patients also had significantly higher overall satisfaction scores than those who did not, although there were no statistically significant differences in individual satisfaction domains. The use of these cellphone, email and text-messaging were also not found to be associated with patient satisfaction domains. Conclusions: Provider provision of their email addresses may be an indicator of a stronger relationship with certain patients. This study elucidates the relationship between provider communication behaviors and patient satisfaction. A better understanding of the role of the patient-provider relationship and its role in patient satisfaction may help practices and providers improve their patients’ experience of primary care.

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