Patients' perspectives regarding antibiotic treatment for acute sinusitis in Norwegian general practice. A qualitative interview study.

Background: The prescription rate for antibiotics for acute sinusitis in primary care remains high, despite evidence showing their limited effectiveness. GPs frequently encounter patient demands for antibiotics, which can influence their decision-making process.

Aim: This study aimed to explore the help-seeking and expectations of patients experiencing symptoms of acute sinusitis, with a particular focus on their desire for antibiotics. We sought to understand why patients seek their GP for sinusitis, what kind of treatment they hope to receive, and how they perceive their influence on the GP's treatment decision.

Methods: We conducted 12 semi-structured interviews with patients who had consulted their GP for acute sinusitis from various regions across Norway. The qualitative analysis was performed using systematic text condensation.

Results: We developed 3 main themes:1. 'Pain and exhaustion'- Patients primarily consulted their GP for acute sinusitis seeking medication to alleviate pain and accelerate recovery.2. 'I trust the GP, but mainly myself'- While patients expressed trust in their GPs, they also had clear expectations of receiving the specific treatment they sought. 3. 'Antibiotics works'- Most patients associated medication with antibiotics and believed they were effective against sinusitis.

Conclusion: Patients with sinusitis primarily visited their GP to seek relief from pain and to obtain medication that they believe could speed up recovery, which often meant antibiotics. These findings suggest a continuing need for measures targeting both doctors and patients to align treatment expectations, improve adherence to clinical guidelines, and adjust patient expectations. Better pain management of sinusitis should be emphasized.