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Health Care, Healthcare, Public Health, Science

Patients Don’t Understand Risks Of Unnecessary Antibiotics, New Study Finds

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Over-prescription of antibiotics is a major factor driving one of the biggest public health concerns today: antibiotic resistance. In a first-of-its-kind study, researchers from the George Washington University found that public health educational materials may not address the misconceptions that shape why patients expect antibiotics, driving doctors to prescribe them more. The research was published recently in the journal Medical Decision Making.

For the study, researchers surveyed 113 patients in an urban hospital to test their understanding of antibiotics. They discovered a widespread misconception: patients may want antibiotics, even if they know that, if they have a viral infection, the drugs will not make them better. These patients believe that taking the medication will not worsen their condition — and that the risk of taking unnecessary antibiotics does not outweigh the possibility that they may help.

“Patients figure that taking antibiotics can’t hurt, and just might make them improve. When they come in for treatment, they are usually feeling pretty bad and looking for anything that will make them feel better. These patients might know that there is, in theory, a risk of side effects when taking antibiotics, but they interpret that risk as essentially nil,” said first author Dr. David Broniatowski, assistant professor in GW’s School of Engineering and Applied Science.

Contrary to these patients’ beliefs, there are substantial risks associated with taking unnecessary antibiotics, such as secondary infections and allergic reactions. But the most serious risk — one that is already playing out — is that eventually, overuse of antibiotics reduces their effectiveness and leads to antibiotic failure. According to one recent study, one in ten antibiotic prescriptions fails to treat the infection for which it was prescribed.

“More than half of the patients we surveyed already knew that antibiotics don’t work against viruses, but they still agreed with taking antibiotics just in case,” Dr. Broniatowski said. “We need to fight fire with fire. If patients think that antibiotics can’t hurt, we can’t just focus on telling them that they probably have a virus. We need to let them know that antibiotics can have some pretty bad side effects, and that they will definitely not help cure a viral infection.”

Dr. Broniatowski’s research found that most educational tools used to communicate the dangers of taking unnecessary antibiotics focus on the differences between bacteria and viruses — the idea that “germs are germs” — but do not address patients’ widespread “why not take a risk” belief.

While the study was small, the results signal the need for a shift in the way health care officials educate patients and caretakers. Dr. Broniatowski urges members of the public health community to reconsider their communication tactics and adjust educational materials to address patients’ concerns and beliefs.

In the future, Mr. Broniatowski and his team, which also included Dr. Eili Klein at Johns Hopkins and Dr. Valerie Reyna at Cornell, hope to test these communication strategies in a clinical setting and, ultimately, reduce the rate of over prescription.



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