J Korean Med Sci.  2017 Feb;32(2):278-286. 10.3346/jkms.2017.32.2.278.

From Visiting a Physician to Expecting Antibiotics: Korean Perspectives and Practices toward Respiratory Tract Infections

• Freidoony
• Kim CB
• Haghani H
• Park MB
• Chang SJ
• Kim SH
• Koh SB

• KMID: 2364172
• DOI: http://doi.org/10.3346/jkms.2017.32.2.278

Abstract

Antibiotic resistance is steadily rising worldwide. Respiratory tract infections (RTIs) are common indications, mostly imprudent, for antibiotic prescriptions in outpatient setting. In Korea, antibiotic prescription rate for RTIs is still high. As physician visit and antibiotic prescribing are influenced by patient's perceptions and beliefs, we aimed to explore the general public's perspectives and practices toward RTIs and to develop the "˜RTI clinical iceberg.' A cross-sectional survey was conducted in Wonju Severance Christian Hospital (WSCH) among 550 adults attending outpatient departments during January 2016. Differences in distributions between groups were examined using two-tailed Pearson χ² test. Using the Andersen's behavioral model as a conceptual framework, we constructed logistic regression models to assess factors associated with physician visit. Of 547 participants with complete questionnaires, 62.9% reported having experienced an RTI in the previous six months; 59.3% visited a physician for the illness, most commonly because the symptoms were severe or prolonged, and approximately 16% of them expected an antibiotic prescription from the visit. Perceptions of symptoms severity, the need factor, most strongly influenced physician visit. Predisposing and enabling factors such as inappropriate expectations for antibiotic for a sore throat or having national health insurance also influenced physician visit. Almost all participants who reported asking for an antibiotic were prescribed one, with a 37.1% non-adherence rate. Conclusively, public education on self-care for RTI symptoms that addresses their main concerns may reduce physician visits. Improving physician-patient relationship and informing patients about the lack of antibiotic benefit for most RTIs may also reduce antibiotic prescriptions.

Keyword

Antibiotics; Respiratory Tract Infections; Expectations; Physician Visit; Attitudes; Practices; Adherence; South Korea

MeSH Terms

Adult
Anti-Bacterial Agents*
Causality
Cross-Sectional Studies
Drug Resistance, Microbial
Education
Gangwon-do
Humans
Korea
Logistic Models
National Health Programs
Outpatients
Pharyngitis
Prescriptions
Respiratory System*
Respiratory Tract Infections*
Self Care
Anti-Bacterial Agents

Figure

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  Fig. 1 The RTI journey of patients: their practices, reasons for physician visit, expectations, beliefs, and attitudes. RTI = respiratory tract infection, WSCH = Wonju Severance Christian Hospital, OTC = over-the-counter.

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  Fig. 2 The respiratory tract infection (RTI) clinical iceberg. *The denominator for all percentages is 344.

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  Fig. 3 Practices reported by all 547 participants regarding antibiotic use in the past year. WSCH = Wonju Severance Christian Hospital, CI = confidence interval.

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