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Expectations for antibiotics increase their prescribing: Causal evidence about localized impact

Sirota, M and Round, T and Samaranayaka, S and Kostopoulou, O (2017) 'Expectations for antibiotics increase their prescribing: Causal evidence about localized impact.' Health Psychology, 36 (4). 402 - 409. ISSN 0278-6133

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Abstract

© 2017 American Psychological Association. Objective: Clinically irrelevant but psychologically important factors such as patients' expectations for antibiotics encourage overprescribing. We aimed to (a) provide missing causal evidence of this effect, (b) identify whether the expectations distort the perceived probability of a bacterial infection either in a preor postdecisional distortions pathway, and (c) detect possible moderators of this effect. Method: Family physicians expressed their willingness to prescribe antibiotics (Experiment 1, n 1 = 305) or their decision to prescribe (Experiment 2, n 2 = 131) and assessed the probability of a bacterial infection in hypothetical patients with infections either with low or high expectations for antibiotics. Response order of prescribing/ probability was manipulated in Experiment 1. Results: Overall, the expectations for antibiotics increased intention to prescribe (Experiment 1, F(1, 301) = 25.32, p < .001, η p 2 = .08, regardless of the response order; Experiment 2, odds ratio [OR] = 2.31, and OR = 0.75, Vignettes 1 and 2, respectively). Expectations for antibiotics did not change the perceived probability of a bacterial infection (Experiment 1, F(1, 301) = 1.86, p = .173, η p 2 = .01, regardless of the response order; Experiment 2, d=-0.03, and d = +0.25, Vignettes 1 and 2, respectively). Physicians' experience was positively associated with prescribing, but it did not moderate the expectations effect on prescribing. Conclusions: Patients' and their parents' expectations increase antibiotics prescribing, but their effect is localized-it does not leak into the perceived probability of a bacterial infection. Interventions reducing the overprescribing of antibiotics should target also psychological factors.

Item Type: Article
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > R Medicine (General)
Divisions: Faculty of Science and Health > Psychology, Department of
Depositing User: Jim Jamieson
Date Deposited: 08 Nov 2016 16:27
Last Modified: 17 Aug 2017 17:23
URI: http://repository.essex.ac.uk/id/eprint/17913

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