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PHE antibiotics campaign welcomed by GPs but a third still experience anger over prescriptions

While nearly 70% of GPs in England say the ‘Keep Antibiotics Working’ campaign is useful, almost a third (32%) say they still frequently experience anger or frustration from patients when advised that antibiotics are not needed, according to a snapshot survey by the Medical Protection Society (MPS).

The MPS survey asked 500 GPs in England their views on the Public Health England awareness campaign which was launched at the end of October 2017 to help patients understand that taking antibiotics when they are not needed puts them at risk of more severe or longer lasting infections. It advised the public to listen to their doctors’ advice.

In the survey, 32% of GPs say that despite the campaign, they still experience anger and frustration from patients wanting antibiotics a few times a week, most days, or every day. 62% said they still experience this occasionally. Furthermore 60% say they have occasionally prescribed antibiotics when patients become angry or frustrated, to avoid confrontation or a complaint. 4% say they do this frequently.

MPS, which assists GPs with responding to and resolving complaints, and helping to stop them occurring in the first place, said it is understandable that GPs feel under pressure, but urged them to feel confident in refusing to prescribe in situations where antibiotics are not needed.

Dr Marika Davies, Senior Medicolegal Adviser at Medical Protection, said: “GPs already spend a considerable amount of time explaining to patients why antibiotics will not help, in order to help them to understand the reasons for a decision not to prescribe. It is encouraging that the PHE campaign appears to be helping some GPs with this, but it will not solve the issues overnight.

“Our survey shows that difficult consultations with patients who want antibiotics even when they aren’t required are still happening. Dealing with these demands is an additional cause of stress to GPs who are already under a great deal of pressure.

“Good communication and management of patient expectations can help in dealing with these situations.  But unfortunately we recognise that some patients will not accept this and will become angry or frustrated when they do not get the treatment they want.

“It is understandable that some GPs feel pressurised into prescribing against their better judgment, but GPs should feel confident to refuse to prescribe in these situations. Patients cannot insist on a particular treatment, and the GMC says that you should only prescribe when you are satisfied that the treatment meets the patient’s needs.

“Prescribing when it is not considered appropriate is not in the best interests of the patient and could put a GP at risk of criticism. GPs should try to explain the reasons for their decision politely and calmly and make notes of the conversation in the patient’s record. If they remain dissatisfied and angry they should be offered the practice’s complaints procedure, and if a complaint is lodged Medical Protection can assist.”

Anonymous quotes from the Medical Protection survey of 500 England based GPs:

“Please carry on with these campaigns as we cannot do it without backup. It is easier to deflect requests if there is information out there”

“Although the campaign has not significantly changed my patient demand, I do find it useful when explaining the irresponsible use of antibiotics and directing patients to take notice of the campaign.”

“Even when I have prescribed the antibiotics due to the expectation and the frustration of the patient, I do warn them that the antibiotics might not work and give them the reasons why I feel that the antibiotics might not work.”

“The campaign is a good idea but I have not seen any concrete benefits so far…this does not mean we should stop trying, just that it may take more time and effort.”

“Patient’s refer to the campaign, but are always convinced their situation is different!”

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