AUTHOR=Colliers Annelies , Bombeke Katrien , Philips Hilde , Remmen Roy , Coenen Samuel , Anthierens Sibyl 

TITLE=Antibiotic Prescribing and Doctor-Patient Communication During Consultations for Respiratory Tract Infections: A Video Observation Study in Out-of-Hours Primary Care

JOURNAL=Frontiers in Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.735276

DOI=10.3389/fmed.2021.735276

ISSN=2296-858X

ABSTRACT=Objective: Communication skills can reduce inappropriate antibiotic prescribing, which could help to tackle antibiotic resistance. General practitioners often overestimate patient expectations for an antibiotic. We describe how general practitioners and patients with respiratory tract infections communicate about their problem, including reason for encounter and ideas, concerns and expectations, and how this relates to (non-)antibiotic prescribing in out-of-hours primary care.
Methods: A qualitative descriptive framework analysis of video-recorded consultations during out-of-hours primary care focusing on doctor-patient communication.
Results: We analysed 77 videos from 19 general practitioners. General practitioners using patient-centred communication skills received more information on the patient’s perspective on the illness period. For some patients the reason for encounter was motivated by their belief that a general practitioner visit will alter the illness course. The ideas, concerns and expectations often remained implicit, but concerns were expressed by choice of words, tone of voice, repetition of words etc. Delayed prescribing was sometimes used to respond to implicit patient expectations for an antibiotic. Patients accepted a non-antibiotic management plan well. 
Conclusion: Not addressing the patients’ ideas, concerns and expectations or reason to consult the out-of-hours general practitioner, could drive assumptions about patient expectations for antibiotics early and antibiotic prescribing later in the consultation.