Impact of reducing antibiotic prescribing for acute bronchitis on patient satisfaction.
BACKGROUND
Using a patient and clinician educational intervention, we successfully reduced antibiotic use for uncomplicated acute bronchitis. The impact of this intervention on patient satisfaction is not known.


OBJECTIVE
To evaluate whether a strategy for reducing antibiotic use in acute bronchitis affects satisfaction among adult patients.


METHODS
Telephone survey administered 1 to 4 weeks after an office visit for acute bronchitis.


METHODS
Two outpatient clinics belonging to a group-model HMO in the Denver, Colorado, metropolitan area. The intervention clinic had received a patient and office-based educational intervention that successfully reduced antibiotic prescribing for acute bronchitis during the previous winter. The control clinic received only the office-based materials, an intervention that did not reduce antibiotic prescribing.


RESULTS
Overall satisfaction with the episode of care.


RESULTS
Antibiotics were prescribed to 64% and 85% of survey respondents at the intervention (n = 102) and control clinics (n = 164), respectively (P < 0.001). Patient satisfaction with the visit did not differ between intervention and control clinics (69% of intervention and 63% of control clinic patients reported very good or excellent satisfaction, P > 0.2). After adjustment for patient age, sex, duration of illness before the visit, reason for visit, and clinician specialty, there was no difference between intervention and control clinics in the proportion of patients reporting very good or excellent satisfaction (adjusted relative risk for high satisfaction at the intervention clinic, 1.1 [95% CI, 0.81 to 1.3]).


CONCLUSIONS
A patient- and clinician-oriented educational intervention that reduces antibiotic treatment of adults with uncomplicated acute bronchitis does not appear to reduce satisfaction with care.
Gonzales
R
R
Division of General Internal Medicine, University of Colorado Health Sciences Center, Denver, Colo., USA. ralphg@medicine.ucsf.edu
Steiner
J F
JF
Maselli
J
J
Lum
A
A
Barrett
P H
PH
D000208:Acute Disease / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001991:Bronchitis / Q000188:drug therapy*; D011307:Drug Prescriptions; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014481:United States
D000900:Anti-Bacterial Agents