Does diagnostic uncertainty increase antibiotic prescribing in primary care?

Abstract This study aimed to determine the association between factors relevant to diagnostic uncertainty and physicians’ antibiotic-prescribing behaviour in primary care. A questionnaire survey was conducted on 327 physicians that measured their diagnostic ability, perceived frequency of diagnostic...

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Autores principales:	Dan Wang, Chaojie Liu, Xinping Zhang, Chenxi Liu
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/7f9ac75afc014a2a854abbe1e4cc690e
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spelling	oai:doaj.org-article:7f9ac75afc014a2a854abbe1e4cc690e2021-12-02T16:36:11ZDoes diagnostic uncertainty increase antibiotic prescribing in primary care?10.1038/s41533-021-00229-92055-1010https://doaj.org/article/7f9ac75afc014a2a854abbe1e4cc690e2021-03-01T00:00:00Zhttps://doi.org/10.1038/s41533-021-00229-9https://doaj.org/toc/2055-1010Abstract This study aimed to determine the association between factors relevant to diagnostic uncertainty and physicians’ antibiotic-prescribing behaviour in primary care. A questionnaire survey was conducted on 327 physicians that measured their diagnostic ability, perceived frequency of diagnostic uncertainty, tolerance, and perceived patient tolerance of uncertainty. Physician antibiotic-prescribing behaviours were assessed based on their prescriptions (n = 207,804) of three conditions: upper respiratory tract infections (URTIs, antibiotics not recommended), acute tonsillitis (cautious use of antibiotics), and pneumonia (antibiotics recommended). A two-level logistic regression model determined the association between diagnostic uncertainty factors and physician antibiotic prescribing. Physicians perceived a higher frequency of diagnostic uncertainty resulting in higher antibiotic use for URTIs and less antibiotic use for pneumonia. Higher antibiotic use for acute tonsillitis was related to a low tolerance of uncertainty of physicians and patients. This study suggests that reducing diagnostic uncertainty and improving physician and patient uncertainty management could reduce antibiotic use.Dan WangChaojie LiuXinping ZhangChenxi LiuNature PortfolioarticleDiseases of the respiratory systemRC705-779ENnpj Primary Care Respiratory Medicine, Vol 31, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the respiratory system RC705-779
spellingShingle	Diseases of the respiratory system RC705-779 Dan Wang Chaojie Liu Xinping Zhang Chenxi Liu Does diagnostic uncertainty increase antibiotic prescribing in primary care?
description	Abstract This study aimed to determine the association between factors relevant to diagnostic uncertainty and physicians’ antibiotic-prescribing behaviour in primary care. A questionnaire survey was conducted on 327 physicians that measured their diagnostic ability, perceived frequency of diagnostic uncertainty, tolerance, and perceived patient tolerance of uncertainty. Physician antibiotic-prescribing behaviours were assessed based on their prescriptions (n = 207,804) of three conditions: upper respiratory tract infections (URTIs, antibiotics not recommended), acute tonsillitis (cautious use of antibiotics), and pneumonia (antibiotics recommended). A two-level logistic regression model determined the association between diagnostic uncertainty factors and physician antibiotic prescribing. Physicians perceived a higher frequency of diagnostic uncertainty resulting in higher antibiotic use for URTIs and less antibiotic use for pneumonia. Higher antibiotic use for acute tonsillitis was related to a low tolerance of uncertainty of physicians and patients. This study suggests that reducing diagnostic uncertainty and improving physician and patient uncertainty management could reduce antibiotic use.
format	article
author	Dan Wang Chaojie Liu Xinping Zhang Chenxi Liu
author_facet	Dan Wang Chaojie Liu Xinping Zhang Chenxi Liu
author_sort	Dan Wang
title	Does diagnostic uncertainty increase antibiotic prescribing in primary care?
title_short	Does diagnostic uncertainty increase antibiotic prescribing in primary care?
title_full	Does diagnostic uncertainty increase antibiotic prescribing in primary care?
title_fullStr	Does diagnostic uncertainty increase antibiotic prescribing in primary care?
title_full_unstemmed	Does diagnostic uncertainty increase antibiotic prescribing in primary care?
title_sort	does diagnostic uncertainty increase antibiotic prescribing in primary care?
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/7f9ac75afc014a2a854abbe1e4cc690e
work_keys_str_mv	AT danwang doesdiagnosticuncertaintyincreaseantibioticprescribinginprimarycare AT chaojieliu doesdiagnosticuncertaintyincreaseantibioticprescribinginprimarycare AT xinpingzhang doesdiagnosticuncertaintyincreaseantibioticprescribinginprimarycare AT chenxiliu doesdiagnosticuncertaintyincreaseantibioticprescribinginprimarycare
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Does diagnostic uncertainty increase antibiotic prescribing in primary care?

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