Br J Health Psychol. 2025 Sep;30(3):e70020. doi: 10.1111/bjhp.70020.
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.
PMID:40891384 | DOI:10.1111/bjhp.70020
