How can general practitioners reduce antibiotic prescribing in collaboration with their patients?

BackgroundMost antibiotics prescribed in primary care are for acute, and often self-limiting, conditions.Patients' expectations of needing antibiotics are an influential driver of general practitioners' (GPs') prescribing behaviour.Better managing patient expectations in consultations for acute infections may be important for reducing prescribing, particularly for self-limiting conditions. ObjectiveThe aim of this article is to increase awareness about patients' beliefs and expectations about antibiotics for acute conditions and provide strategies and resources that GPs can use in collaboration with their patients for managing these expectations. DiscussionExpectations of antibiotics may reflect a desire for symptomatic treatment, lack of awareness of other options or previous experience.Consultations for many acute conditions are particularly suited to shared decision making -it enables discussion about expectations and antibiotic benefits and harms and assists patients to make an informed decision.Delayed prescribing is another evidence-based strategy that can be used as part of shared decision making. ANTIBIOTICS ARE PRESCRIBED MORE OFTEN IN PRIMARY CAREthan other settings, with 42% of the Australian population being given at least one antibiotic prescription in 2017. 1 Many of the conditions for which antibiotics are prescribed are self-limiting conditions, and antibiotics are often not needed, such as acute respiratory infections (ARIs) such as sore throat, acute bronchitis and acute otitis media (AOM).[2][3][4] These conditions are highly prevalent in general practice, and antibiotics are overprescribed at rates 4-9 times as high as those recommended by Australian guidelines.5 General practitioners (GPs) are almost three times more likely to prescribe an antibiotic for their patients if they believe that the patients expect it.6 Perceived patient demand has been found to have a significant and independent effect on prescribing.7 There is often limited exploration and management of antibiotic expectations in consultations.8 Better managing patient expectations in consultations for acute infections may be important for reducing prescribing, particularly for self-limiting conditions.How can general practitioners reduce antibiotic prescribing in collaboration with their patients?