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BMC Primary Care
Published in: BMC Primary Care 1/2018

Open Access 01-12-2018 | Research article

The influence of gender concordance between general practitioner and patient on antibiotic prescribing for sore throat symptoms: a retrospective study

Published in: BMC Primary Care | Issue 1/2018

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Abstract

Background

Patient gender as well as doctor gender are known to affect doctor-patient interaction during a medical consultation. It is however not known whether an interaction of gender influences antibiotic prescribing. This study examined GP’s prescribing behavior of antibiotics at the first presentation of patients with sore throat symptoms in primary care. We investigated whether GP gender, patient gender and gender concordance have an effect on the GP’s prescribing behavior of antibiotics in protocolled and non-protocolled diagnoses.

Methods

We analyzed electronic health record data of 11,285 GP practice consultations in the Netherlands in 2013 extracted from the Nivel Primary Care Database. Our primary outcome was the prescription of antibiotics for throat symptoms. Sore throat symptoms were split up in ‘protocolled diagnoses’ and ‘non-protocolled diagnoses’. The association between gender concordance and antibiotic prescription was estimated with multilevel regression models that controlled for patient age and comorbidity.

Results

Antibiotic prescription was found to be lower among female GPs (OR 0.88, CI 95% 0.67–1.09; p = .265) and female patients (OR 0.93, 95% 0.84–1.02; p = .142), but observed differences were not statistically significant. The difference in prescription rates by gender concordance were small and not statistically significant in non-protocolled consultations (OR 0.92, OR 95% CI: 0.83–1.01; p = .099), protocolled consultations (OR 1.00, OR 95% CI: 0.68–1.32; p = .996) and all GP practice consultations together (OR 0.92, OR 95% CI: 0.82–1.02; p = .118). Within the female GP group, however, gender concordance was associated with reduced prescribing of antibiotics (OR 0.85, OR 95% CI: 0.72–0.99; p = 0.034).

Conclusions

In this study, female GPs prescribed antibiotics less often than male GPs, especially in consultation with female patients. This study shows that, in spite of clinical guidelines, gender interaction may influence the prescription of antibiotics with sore throat symptoms.
Literature
1.
Prestinaci F, Pezzotti P, Pantosti A. Antimicrobial resistance: a global multifaceted phenomenon. Pathogens and global health. 2015;109(7):309–18.CrossRef
2.
Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ. 2010;340:c2096.CrossRef
3.
Vazquez-Lago JM, Lopez-Vazquez P, López-Durán A, Taracido-Trunk M, Figueiras A. Attitudes of primary care physicians to the prescribing of antibiotics and antimicrobial resistance: a qualitative study from Spain. Fam Pract. 2012;29(3):352–60.CrossRef
4.
Teixeira Rodrigues A, Roque F, Falcao A, Figueiras A, Herdeiro MT. Understanding physician antibiotic prescribing behaviour: a systematic review of qualitative studies. Int J Antimicrob Agents. 2013;41(3):203–12.CrossRef
5.
Akkerman AE, Kuyvenhoven MM, van der Wouden JC, Verheij TJ. Prescribing antibiotics for respiratory tract infections by GPs: management and prescriber characteristics. Br J Gen Pract. 2005;55(511):114–8.PubMedPubMedCentral
6.
Lado E, Vacariza M, Fernandez-Gonzalez C, Gestal-Otero JJ, Figueiras A. Influence exerted on drug prescribing by patients’ attitudes and expectations and by doctors’ perception of such expectations: a cohort and nested case-control study. J Eval Clin Pract. 2008;14(3):453–9.CrossRef
7.
Altiner A, Knauf A, Moebes J, Sielk M, Wilm S. Acute cough: a qualitative analysis of how GPs manage the consultation when patients explicitly or implicitly expect antibiotic prescriptions. Fam Pract. 2004;21(5):500–6.CrossRef
8.
Coenen S, Francis N, Kelly M, Hood K, Nuttall J, Little P, et al. Are patient views about antibiotics related to clinician perceptions, management and outcome? A multi-country study in outpatients with acute cough. PLoS One. 2013;8(10):e76691.CrossRef
9.
Bertakis KD. The influence of gender on the doctor–patient interaction. Patient Educ Couns. 2009;76(3):356–60.CrossRef
10.
Adams A, Buckingham CD, Lindenmeyer A, McKinlay JB, Link C, Marceau L, et al. The influence of patient and doctor gender on diagnosing coronary heart disease. Sociology of health & illness. 2008;30(1):1–18.CrossRef
11.
Franks P, Bertakis KD. Physician gender, patient gender, and primary care. J Women's Health. 2003;12(1):73–80.CrossRef
12.
van den Brink-Muinen A. Sekseverschillen en de communicatie tussen huisarts en patiënt. Bijblijven. 2008;24:7–13.CrossRef
13.
Lagro-Janssen AL. Medicine is not gender-neutral: influence of physician sex on medical care. Ned Tijdschr Geneeskd. 2008;152(20):1141–5.PubMed
14.
STEWART M. Patient characteristics which are related to the doctor-patient interaction. Fam Pract. 1984;1(1):30–6.CrossRef
15.
Grunau GL, Ratner PA, Galdas PM, Hossain S. Ethnic and gender differences in patient education about heart disease risk and prevention. Patient Educ Couns. 2009;76(2):181–8.CrossRef
16.
Van den Brink-Muinen A, van Dulmen S, Messerli-Rohrbach V, Bensing J. Do gender-dyads have different communication patterns? A comparative study in Western-European general practices. Patient Educ Couns. 2002;48(3):253–64.CrossRef
17.
Sandhu H, Adams A, Singleton L, Clark-Carter D, Kidd J. The impact of gender dyads on doctor-patient communication: a systematic review. Patient Educ Couns. 2009;76(3):348–55.CrossRef
18.
Bertakis KD, Azari R. Patient-centered care: the influence of patient and resident physician gender and gender concordance in primary care. J Womens Health (Larchmt). 2012;21(3):326–33.CrossRef
19.
Schmittdiel JA, Traylor A, Uratsu CS, Mangione CM, Ferrara A, Subramanian U. The association of patient-physician gender concordance with cardiovascular disease risk factor control and treatment in diabetes. J Womens Health (Larchmt). 2009;18(12):2065–70.CrossRef
20.
Pickett-Blakely O, Bleich SN, Cooper LA. Patient-physician gender concordance and weight-related counseling of obese patients. Am J Prev Med. 2011;40(6):616–9.CrossRef
21.
Woolf SH, Grol R, Hutchinson A, Eccles M, Grimshaw J. Clinical guidelines: potential benefits, limitations, and harms of clinical guidelines. BMJ. 1999;318(7182):527.CrossRef
22.
Dekker AR, Verheij TJ, van der Velden AW. Inappropriate antibiotic prescription for respiratory tract indications: most prominent in adult patients. Fam Pract. 2015;32(4):401–7.PubMed
23.
Butler CC, Hillier S, Roberts Z, Dunstan F, Howard A, Palmer S. Antibiotic-resistant infections in primary care are symptomatic for longer and increase workload: outcomes for patients with E. coli UTIs. Br J Gen Pract. 2006;56(530):686–92.PubMedPubMedCentral
24.
Wood M, Lamberts H. International classification of primary care: prepared for the world organisation of national colleges, academies and academic associations of general practitioners/family physicians (WONCA) by the ICPC working party. Oxford: Oxford University Press; 1987.
25.
26.
Tates K, Meeuwesen L, Elbers E, Bensing J. I've come for his throat’: roles and identities in doctor-parent-child communication. Child Care Health Dev. 2002;28(1):109–16.CrossRef
27.
28.
Zwart SDCF. Diagnostiek van alledaagse klachten. 3rd ed: BSL; 2011.
29.
Schieber AC, Delpierre C, Lepage B, Afrite A, Pascal J, Cases C, et al. Do gender differences affect the doctor-patient interaction during consultations in general practice? Results from the INTERMEDE study. Fam Pract. 2014;31(6):706–13.CrossRef
30.
Hashim MJ. Patient-Centered Communication: Basic Skills. Am Fam Physician. 2017;95(1):29–34.PubMed
31.
Matthys J, Elwyn G, Van Nuland M, Van Maele G, De Sutter A, De Meyere M, et al. Patients’ ideas, concerns, and expectations (ICE) in general practice: impact on prescribing. Br J Gen Pract. 2009;59(558):29–36.CrossRef
32.
Mehta N, Schilder A, Fragaszy E, H ERE, Dukes O, Manikam L, et al. Antibiotic prescribing in patients with self-reported sore throat. J Antimicrob Chemother. 2017;72(3):914–22.PubMed
33.
Goossens H, Ferech M, Vander Stichele R, Elseviers M. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet (London, England). 2005;365(9459):579–87.CrossRef
34.
Bont J, Hak E, Birkhoff CE, Hoes AW, Verheij TJ. Is co-morbidity taken into account in the antibiotic management of elderly patients with acute bronchitis and COPD exacerbations? Fam Pract. 2007;24(4):317–22.CrossRef
35.
Verheij RA, Curcin V, Brendan BC, McGilchrist MM. Possible sources of Bias in primary care electronic health record data (re) use. J Med Internet Res. 2018;20(5):e185.CrossRef
36.
van der Velden LF, Hingstman L, Heiligers PJ, Hansen J. Increasing number of women in medicine: past, present and future. Ned Tijdschr Geneeskd. 2008;152(40):2165–71.PubMed
Metadata
Title
The influence of gender concordance between general practitioner and patient on antibiotic prescribing for sore throat symptoms: a retrospective study
Publication date
01-12-2018
Published in
BMC Primary Care / Issue 1/2018
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-018-0859-6

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