title: Back-up antibiotic prescriptions for common respiratory symptoms. Patient satisfaction and fill rates.
abstract: BACKGROUND
  In recent years much has been written about the overuse of antibiotics, especially for common respiratory illnesses. One approach to this issue 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 to determine patient satisfaction, prescription fill rates, and correlates of these outcomes among patients receiving back-up antibiotic prescriptions.
  
  
  METHODS
  In our observational study we obtained survey data from 28 physicians and 2 physician extenders in 3 family practice clinics and their patients presenting with complaints of common respiratory symptoms. We computed patient satisfaction and fill rates of back-up antibiotic prescriptions. Agreement between the perceived need of patients for antibiotics before the office visit and the subjective rating of their physicians of the clinical necessity to prescribe antibiotics for these patients was assessed using the kappa statistic. Finally, we determined correlates of satisfaction and the rate of filling back-up prescriptions.
  
  
  RESULTS
  Of the 947 patients enrolled in the study, 46.6% received no antibiotic prescriptions, 30.2% received back-up antibiotic prescriptions, and 23.2% were given immediate-fill prescriptions for an antibiotic. Patients' self-reported satisfaction and fill rates for back-up antibiotic prescriptions 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 not to fill these prescriptions suggests a potential health care cost savings.
authors.affiliation: Department of Family Medicine, Scot & White Memorial Hospital and Clinic, USA. gcouchman@swmail.sw.org
authors.forename: G R
authors.initials: GR
authors.lastname: Couchman
authors.forename: T G
authors.initials: TG
authors.lastname: Rascoe
authors.forename: S N
authors.initials: SN
authors.lastname: Forjuoh
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D005194:Family Practice; D006801:Humans; D008171:Lung Diseases / Q000188:drug therapy*; D017060:Patient Satisfaction
chemical_list: D000900:Anti-Bacterial Agents