RTI patients prescribed antibiotics during virtual visits more satisfied than others

Patients tend to rate doctors higher when they are prescribed antibiotics–even if the medicines aren't needed, according to new research. Respiratory tract infection (RTI) patients who were prescribed antibiotics during virtual visits rated their physicians better than patients who weren’t prescribed any antibiotics.

The findings were detailed in a research letter authored by Cleveland Clinic researchers Kathryn A. Martinez, PhD; Mark Rood, MD; and Nikhyl Jhangiani, MPH, MBA; et al. and published in JAMA Internal Medicine on Monday, Oct. 1.

Despite outpatient RTIs rarely requiring antibiotics for treatment, physicians frequently prescribe them to treat the infections, a decision that may come from physicians thinking patient satisfaction will be lower if they don’t.

To test that theory, the authors analyzed RTI patients’ satisfaction with physicians after using a direct-to-consumer telemedicine platform. The study was conducted between Jan. 2013 and Aug. 2016 and collected 8,437 encounters with 85 physicians.

Among RTI patients, 66.1 percent were prescribed an antibiotic; 18.3 percent were not prescribed anything; and 15.5 percent were prescribed a non-antibiotic medication.

Patients rated satisfaction with their physician from 0 to 5 stars, with 5 being the most satisfied. About 72.5 percent of the patients who didn’t receive a prescription rated satisfaction as five stars, while 86 percent of patients who received a non-antibiotic prescription rated their satisfaction as five stars. Additionally, 90.9 percent of patients who received an antibiotic prescription gave their satisfaction with their physician five stars.

“In direct-to-consumer telemedicine, antibiotic prescribing for RTIs is common, and patients who receive antibiotics for RTIs are more satisfied,” Martinez et al. wrote. “Prescribing non-antibiotic medications may improve satisfaction ratings without increasing unwarranted use of antibiotics, yet counter-incentives may also be required to reduce antibiotic prescribing in this setting.”

The authors also noted their study was limited and only conducted from one telemedicine platform, so it may not be “representative of the field at large.”