Back-up antibiotic prescriptions for common respiratory symptoms - Patientsatisfaction and fill rates

BACKGROUND In recent years much has been written about the overuse of antib iotics, especially for common respiratory illnesses. One approach to this i ssue is the use of a back-up prescription, only to be filled if a patient's condition deteriorates or fails to improve. The purpose of our study was t o determine patient satisfaction, prescription fill rates, and correlates o f these outcomes among patients receiving back-up antibiotic prescriptions. METHODS In our observational study we obtained survey data from 28 physicia ns and 2 physician extenders in 3 family practice clinics and their patient s presenting with complaints of common respiratory symptoms. We computed pa tient satisfaction and fill rates of back-up antibiotic prescriptions. Agre ement between the perceived need of patients for antibiotics before the off ice visit and the subjective rating of their physicians of the clinical nec essity to prescribe antibiotics for these patients was assessed using the k appa statistic. Finally, we determined correlates of satisfaction and the r ate of filling back-up prescriptions. RESULTS Of the 947 patients enrolled in the study, 46.6% received no antibi otic prescriptions, 30.2% received back-up antibiotic prescriptions, and 23 .2% were given immediate-fill prescriptions for an antibiotic. Patients' se lf- reported satisfaction and fill rates for back-up antibiotic prescriptio ns were 96.1% and 50.2%, respectively. CONCLUSIONS Our findings indicate that patients were very satisfied with a back-up antibiotic prescription. The fact that half of the patients chose n ot to fill these prescriptions suggests a potential health care cost saving s.