The effects of communicating illness diagnostic and treatment information and C-reactive protein test results on people's antibiotic expectations

IF 2.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology Pub Date : 2025-09-02 DOI:10.1111/bjhp.70020

Andriana Theodoropoulou, Matteo Lisi, Jonathan Rolision, Miroslav Sirota

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引用次数: 0

Abstract

Objectives

Patients' expectations for antibiotics are among the strongest predictors of clinicians' decisions to overprescribe antibiotics. In this registered report, we used a signal detection theory framework to investigate the experimental effects of the communication interventions that family physicians can use to reduce patients' diagnostic uncertainty, and consequently, their antibiotic expectations.

Methods

UK participants (N = 769) read hypothetical consultations for respiratory tract infections and were randomly assigned to one of three conditions: standard information (control), recommended information about the nature of the illness and antibiotic efficacy (recommended communication) or recommended information accompanied by point-of-care test results (recommended communication and CRP). Using a multilevel Bayesian probit regression, we estimated both decision bias (criterion) and sensitivity (d-prime).

Results

Aligned with our bias hypotheses, participants displayed a more liberal antibiotic bias in the control condition compared to both the recommended communication (Δc = −1.34, 95% CI [−1.57, −1.11]) and the recommended communication and CRP (Δc = −1.73, 95% CI [−1.99, −1.48]) conditions. They also showed greater liberal bias in the recommended communication condition compared to the recommended communication and CRP condition (Δc = −0.39, 95% CI [−0.65, 0.13]). Aligned with our sensitivity hypotheses, participants displayed significantly higher sensitivity in both the recommended communication (Δd' = 2.34, 95% CI [1.92, 2.79]) and the recommended communication and CRP (Δd' = 2.49, 95% CI [2.08, 2.95]) conditions compared to control.

Conclusions

Simple, evidence-based communication strategies—particularly when combined with diagnostic test results—can reduce antibiotic expectations, offering practical tools for clinicians to support appropriate prescribing.

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沟通疾病诊疗信息和c反应蛋白检测结果对人们抗生素预期的影响

患者对抗生素的期望是临床医生决定过度开抗生素的最强预测因素之一。在这篇注册报告中，我们使用信号检测理论框架来研究沟通干预的实验效果，家庭医生可以使用这种干预来减少患者的诊断不确定性，从而减少他们对抗生素的期望。方法英国参与者（N = 769）阅读呼吸道感染的假设咨询，并随机分配到以下三种情况中的一种：标准信息（对照），关于疾病性质和抗生素疗效的推荐信息（推荐沟通）或推荐信息伴护理点检测结果（推荐沟通和CRP）。使用多水平贝叶斯概率回归，我们估计了决策偏差（标准）和灵敏度（d-prime）。结果与我们的偏倚假设一致，与推荐的沟通（Δc = - 1.34, 95% CI[- 1.57, - 1.11]）和推荐的沟通和CRP （Δc = - 1.73, 95% CI[- 1.99, - 1.48]）相比，对照条件下的参与者表现出更自由的抗生素偏倚。与推荐沟通和CRP条件相比，他们在推荐沟通条件上也表现出更大的自由偏差（Δc = - 0.39, 95% CI[- 0.65, 0.13]）。与我们的敏感性假设一致，与对照组相比，参与者在推荐的沟通（Δd' = 2.34, 95% CI[1.92, 2.79]）和推荐的沟通和CRP （Δd' = 2.49, 95% CI[2.08, 2.95]）条件下都表现出显著更高的敏感性。结论：简单的循证沟通策略，特别是与诊断测试结果相结合时，可以降低对抗生素的期望，为临床医生提供实用工具，以支持适当的处方。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Health Psychology PSYCHOLOGY, CLINICAL-

CiteScore

14.10

自引率

1.30%

发文量

期刊介绍： The focus of the British Journal of Health Psychology is to publish original research on various aspects of psychology that are related to health, health-related behavior, and illness throughout a person's life. The journal specifically seeks articles that are based on health psychology theory or discuss theoretical matters within the field.