Reducing inappropriate expectations and requests for antibiotics

Responding to substantial inappropriate prescribing of antibiotics, interventions have aimed to reduce patients’ expectations and requests for antibiotics by focussing on the provision of didactic information. Such interventions assume that patients lack information about diseases and antibiotics, but these are hard to evaluate in complex interventions.

In two pre-registered studies, we first identify the dimensions of individuals’ beliefs about diseases and antibiotics that are associated with, and predict, expectations to receive and/or request antibiotics from a GP. Second, we examine the causal link between the provision of information about diseases and antibiotics from a GP and individuals’ expectations and requests for antibiotics.  We find evidence that the provision of information regarding the efficacy and side effects of antibiotics decreases, but does not diminish clinically inappropriate expectations and requests.

The effect is small and partly depends on individuals’ prior beliefs. We observe no effect of information relating to the nature of the illness on expectations and requests. We suggest that interventions attempting to reduce expectations and requests should explore additional factors that will lead to a synergic effect.