title: Antibiotic prescribing and patient satisfaction in primary care in England: cross-sectional analysis of national patient survey data and prescribing data.
abstract: BACKGROUND
  Concerns about adverse effects on patient satisfaction may be an important obstacle to attempts to curtail antibiotic prescribing.
  
  
  OBJECTIVE
  To determine the relationship between antibiotic prescribing in general practice and reported patient satisfaction.
  
  
  METHODS
  Retrospective cross-sectional study of general practices in England.
  
  
  METHODS
  Data were obtained from the General Practice Patient Survey (GPPS) in 2012 (2.7 million questionnaires in England; 982 999 responses; response rate 36%); the national Quality and Outcomes Framework dataset for England, 2011-2012 (8164 general practices); and general practice and demographic characteristics. Standardised measures of antibiotic prescribing volumes were obtained for each practice in England during 2012-2013, together with 12 other nationally available prescribing variables. The role of antibiotic prescribing volume was identified as a determinant of GPPS scores and adjusted for demographic and practice factors using multiple linear regression.
  
  
  RESULTS
  The final dataset consisted of 7800 (95.5%) practices. A total of 33.7 million antibiotic prescriptions were issued to a registered population of 53.8 million patients. Antibiotic prescribing volume was a significant positive predictor of all 'doctor satisfaction' and 'practice satisfaction' scores in the GPPS, and was the strongest predictor of overall satisfaction out of 13 prescribing variables. A theoretical 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 ranking.
  
  
  CONCLUSIONS
  Patients were less satisfied in practices with frugal antibiotic prescribing. A cautious approach to antibiotic prescribing may require a trade-off in terms of patient satisfaction.
authors.affiliation: Department of Primary Care and Public Health Sciences, King's College London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Ashworth
authors.affiliation: Department of Primary Care and Public Health Sciences, King's College London, UK.
authors.forename: Patrick
authors.initials: P
authors.lastname: White
authors.affiliation: Department of Primary Care and Public Health Sciences, King's College London, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Jongsma
authors.affiliation: Department of Primary Care and Public Health Sciences, King's College London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Schofield
authors.affiliation: Department of Primary Care and Public Health Sciences, King's College London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Armstrong
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D007239:Infections / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011159:Population Surveillance; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotic prescribing; antibiotics; patient experience; patient satisfaction; primary health care