What are the non-biomedical reasons which make family doctors over-prescribe antibiotics for upper respiratory tract infection in a mixed private/public Asian setting?

Abstract

Objectives: To examine the non-biomedical reasons which make family doctors over-prescribe antibiotics for upper respiratory tract infection (URTI) in a mixed private/public Asian setting. Methods: The questionnaire was sent to the members of the Hong Kong College of Family Physicians between August and December 2001. Results: A total of 801 family doctors completed a postal questionnaire with an overall response rate of 65.0%. A significant number of respondents (21.8%) felt they might be prescribing antibiotics too often for URTI but the majority of them felt they were using antibiotics just a bit too often. Doctors who were older, more senior or in private practice were more likely to feel that they might be prescribing antibiotics too often. More than 50% of respondents thought that to satisfy the patient or his/her carer and fear of medicolegal problem if the patient deteriorates would make them very likely or likely to over-prescribe antibiotics for patients with URTIs. Public doctors might over-prescribe in order to save time, whereas private doctors might do so in order to keep patients in their practice. Conclusion: The results showed that doctors with certain characteristics are more likely to overprescribe antibiotics. Factors, other than biomedical ones, may play important roles in doctor's prescription of antibiotics for URTI.