GPs who prescribe fewer antibiotics get lower patient satisfaction scores

GPs who refuse to prescribe antibiotics to patients are likely to receive poorer patient satisfaction scores, a study published in the British Journal of General Practice (online, 7 December 2015) suggests^[1]
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Researchers at King’s College London matched antibiotic prescribing rates at general practices in England in 2012–2013 to the patient satisfaction scores achieved in the 2012 General Practice Patient Survey (GPPS). 

The data covers 95.5% of the practices in England; a total of 33.7 million antibiotic prescriptions were issued to a registered population of 53.8 million patients at 7,800 practices in 2012–2013. 

Antibiotic prescribing volume was a significant indicator of patient satisfaction with their doctor, and to a lesser extent their practice. Antibiotic prescribing was the strongest indicator of overall satisfaction out of 13 prescribing variables collected nationally, these included net ingredient cost per 1,000 registered patients, and prescribing volumes of oral non-steroidal anti-inflammatory drugs and antidepressants. 

The researchers warned that “a cautious approach to antibiotic prescribing may require a trade-off in terms of patient satisfaction”. Their results indicated that a 25% reduction in antibiotic prescribing volume would be associated with 0.5–1.0% lower patient satisfaction scores, a drop of 3–6 centile points in national satisfaction rankings. 

Tim Ballard, vice chair of the Royal College of GPs, says: “It’s concerning that patients associate a prescription for antibiotics with a satisfactory visit to their GP, particularly as we know that in many cases antibiotics are not appropriate forms of treatment and could actually do more harm than good.” 

“It’s also frustrating that GP practices that are working hard to reduce inappropriate antibiotics prescribing in order to prevent diseases becoming resistant to them face falling patient satisfaction ratings. It truly is a case of being damned if we do and damned if we don’t,” he adds. 

“Public perception needs to change – our patients need to understand that when diseases become resistant to antibiotics, it means that antibiotics will cease to work and as it stands, we don’t have an alternative.”