Data from: Why do general practitioners prescribe antibiotics for upper respiratory tract infections to meet patient expectations: a mixed methods study

Objectives To describe the role patient expectations play in general practitioners (GPs) antibiotic prescribing for upper respiratory tract infections. Methods Concurrent explanatory mixed methods approach using a cross sectional survey and semi structured interviews Settings Primary care general practitioners in Australia Participants 584 general practitioners (response rate of 23.6%) completed the cross sectional survey. 32 general practitioners were interviewed individually. Outcome measure: Prescribing of antibiotics for upper respiratory tract infection Results More than half of the GPs in Australia self-reported that they would prescribe antibiotics for an upper respiratory tract infection (URTI) to meet patient expectations. Our qualitative findings suggest that ‘patient expectations’ may be the main reason given for inappropriate prescribing but it is an all-encompassing phrase that includes other reasons. These include limited time, poor doctor-patient communication, and diagnostic uncertainty. We have identified three role archetypes to explain the behaviour of GPs in reference to antibiotic prescribing for URTIs. The main themes emerging from the qualitative component was that many GPs did not think that antibiotic prescribing in primary care was responsible for the development of antibiotic resistance nor that their individual prescribing would make any difference in light of other bigger issues like hospital prescribing or veterinary use. For them, there were negligible negative consequences from their inappropriate prescribing. Conclusions There is a need to increase awareness of the scope and magnitude of antibiotic resistance and the role primary care prescribing plays, and of the contribution of individual prescribing decisions to the problem of antibiotic resistance.研究目的：阐明患者期望在全科医师（general practitioners，简称GPs）针对上呼吸道感染（upper respiratory tract infections，简称URTIs）开具抗生素处方中的作用。 研究方法：采用并行解释性混合研究设计，结合横断面调查与半结构化访谈。 研究场景：澳大利亚基层医疗领域的全科医师。 研究对象：共584名全科医师完成横断面调查，应答率为23.6%；另有32名全科医师接受单独访谈。 结局指标：上呼吸道感染的抗生素处方情况。 研究结果：澳大利亚超过半数的全科医师自我报告称，会为满足患者期望而为上呼吸道感染患者开具抗生素处方。定性研究结果显示，"患者期望"或许是不合理抗生素处方被提及的主要原因，但该术语实为涵盖性表述，其内涵还包含接诊时间有限、医患沟通不足、诊断不确定性等其他因素。本研究明确了三类可解释全科医师上呼吸道感染抗生素处方行为的角色原型。定性研究的核心主题还包括：许多全科医师认为，基层医疗的抗生素处方并非导致抗生素耐药性（antibiotic resistance）的原因，且相较于医院处方或兽药使用等更大的问题，个体的处方行为不会产生实质性影响；在他们看来，自身不合理处方所带来的负面影响微乎其微。 研究结论：亟需提升公众对抗生素耐药性的范围与程度、基层医疗处方在其中发挥的作用，以及个体处方决策对抗生素耐药性问题的贡献的认知。