Some patients are more satisfied when they are given usually unnecessary antibiotics for upper respiratory infections

Research Activities, May 2010, No. 357

People suffering from acute upper respiratory tract infections, which are usually caused by viruses, often leave emergency departments (EDs) armed with an antibiotic prescription. Unfortunately, these drugs are ineffective in treating viral conditions and contribute to antibiotic resistance. Nevertheless, some patients give higher satisfaction ratings to EDs that provide prescriptions for antibiotics, reveals a new study.

Surveying 463 patients who received care at 8 Veterans Administration (VA) EDs and 496 patients seen at 8 non-VA EDs, researchers found that patients at the non-VA hospitals were more satisfied with their visits when they received a prescription for antibiotics. In fact, 64 percent of patients at non-VA hospitals who received antibiotics reported high levels of overall satisfaction compared with 50 percent of patients who did not receive prescriptions. Patients who received antibiotic prescriptions also reported higher satisfaction levels for the explanations they received and the quality of provider care.

The study authors suggest that receiving antibiotics may validate the seriousness of the condition and necessity for the ED trip for the patient. On the other hand, antibiotics may cause a placebo effect, resulting in quicker recovery times. While providing antibiotics flies in the face of evidence-based medicine, some providers may feel pressure to provide them because satisfaction ratings are linked to pay-for-performance quality measures, note the researchers.

It should be noted that receiving antibiotics did not affect satisfaction levels for patients seen at VA sites. The authors suggest that because EDs may be located at the same VA site where patients receive their primary care services, followup care may be easier to obtain. This study was funded in part by a grant from the Agency for Healthcare Research and Quality (HS13915) to the University of Pennsylvania Center for Education and Research on Therapeutics (CERT). For more information on the CERTs program, visit http://www.certs.hhs.gov.

See "Antibiotic prescriptions are associated with increased patient satisfaction with emergency department visits for acute respiratory tract infections," by Cordelia R. Stearns, Ralph Gonzales, M.D., M.S.P.H., Carlos A. Camargo, Jr., M.D., Dr.Ph., and others in Academic Emergency Medicine 16(10), pp. 934-941, 2009.

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