Association of antibiotics with veteran visit satisfaction and antibiotic expectations for upper respiratory tract infections
Abstract Background and objective: Veterans’ Affairs (VA) healthcare providers perceive that Veterans expect and base visit satisfaction on receiving antibiotics for upper respiratory tract infections (URIs). No studies have tested this hypothesis. We sought to determine whether receiving and/or e...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2022-01-01
|
| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X22002339/type/journal_article |
| _version_ | 1827995869284139008 |
|---|---|
| author | Milner B. Staub Rachael Pellegrino Erin Gettler Morgan C. Johnson Christianne L. Roumie Carlos G. Grijalva Kaitlyn Reasoner Robert S. Dittus Todd Hulgan |
| author_facet | Milner B. Staub Rachael Pellegrino Erin Gettler Morgan C. Johnson Christianne L. Roumie Carlos G. Grijalva Kaitlyn Reasoner Robert S. Dittus Todd Hulgan |
| author_sort | Milner B. Staub |
| collection | DOAJ |
| description |
Abstract
Background and objective:
Veterans’ Affairs (VA) healthcare providers perceive that Veterans expect and base visit satisfaction on receiving antibiotics for upper respiratory tract infections (URIs). No studies have tested this hypothesis. We sought to determine whether receiving and/or expecting antibiotics were associated with Veteran satisfaction with URI visits.
Methods:
This cross-sectional study included Veterans evaluated for URI January 2018–December 2019 in an 18-clinic ambulatory VA primary-care system. We evaluated Veteran satisfaction via the Patient Satisfaction Questionnaire Short Form (RAND Corporation), an 18-item 5-point Likert scale survey. Additional items assessed Veteran antibiotic expectations. Antibiotic receipt was determined via medical record review. We used multivariable regression to evaluate whether antibiotic receipt and/or Veteran antibiotic expectations were associated with satisfaction. Subgroup analyses focused on Veterans who accurately remembered antibiotic prescribing during their URI visit.
Results:
Of 1,329 eligible Veterans, 432 (33%) participated. Antibiotic receipt was not associated with differences in mean total satisfaction (adjusted score difference, 0.6 points; 95% confidence interval [CI], −2.1 to 3.3). However, mean total satisfaction was lower for Veterans expecting an antibiotic (adjusted score difference −4.4 points; 95% CI −7.2 to −1.6). Among Veterans who accurately remembered the visit and did not receive an antibiotic, those who expected an antibiotic had lower mean satisfaction scores than those who did not (unadjusted score difference, −16.6 points; 95% CI, −24.6 to −8.6).
Conclusions:
Veteran expectations for antibiotics, not antibiotic receipt, are associated with changes in satisfaction with outpatient URI visits. Future research should further explore patient expectations and development of patient-centered and provider-focused interventions to change patient antibiotic expectations.
|
| first_indexed | 2024-04-10T05:03:10Z |
| format | Article |
| id | doaj.art-fe2fb18cc5d04891a3b34451ddf8d624 |
| institution | Directory Open Access Journal |
| issn | 2732-494X |
| language | English |
| last_indexed | 2024-04-10T05:03:10Z |
| publishDate | 2022-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj.art-fe2fb18cc5d04891a3b34451ddf8d6242023-03-09T12:28:16ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2022-01-01210.1017/ash.2022.233Association of antibiotics with veteran visit satisfaction and antibiotic expectations for upper respiratory tract infectionsMilner B. Staub0https://orcid.org/0000-0002-0774-7698Rachael Pellegrino1Erin Gettler2https://orcid.org/0000-0003-1071-9898Morgan C. Johnson3https://orcid.org/0000-0002-4799-8715Christianne L. Roumie4Carlos G. Grijalva5Kaitlyn Reasoner6Robert S. Dittus7Todd Hulgan8Geriatric Research, Education, and Clinical Center (GRECC), Veterans Health Administration, Tennessee Valley Healthcare System, Nashville, Tennessee Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TennesseeDepartment of Medicine, Vanderbilt University Medical Center, Nashville, TennesseeDivision of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TennesseeGeriatric Research, Education, and Clinical Center (GRECC), Veterans Health Administration, Tennessee Valley Healthcare System, Nashville, TennesseeGeriatric Research, Education, and Clinical Center (GRECC), Veterans Health Administration, Tennessee Valley Healthcare System, Nashville, Tennessee Department of Medicine, Vanderbilt University Medical Center, Nashville, TennesseeDivision of Pharmacoepidemiology, Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee (Present affiliation: Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina [E.G.]).Department of Medicine, Vanderbilt University Medical Center, Nashville, TennesseeGeriatric Research, Education, and Clinical Center (GRECC), Veterans Health Administration, Tennessee Valley Healthcare System, Nashville, Tennessee Department of Medicine, Vanderbilt University Medical Center, Nashville, TennesseeDivision of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Infectious Diseases Section, Medical Services, Tennessee Valley Healthcare System, Nashville, Tennessee Abstract Background and objective: Veterans’ Affairs (VA) healthcare providers perceive that Veterans expect and base visit satisfaction on receiving antibiotics for upper respiratory tract infections (URIs). No studies have tested this hypothesis. We sought to determine whether receiving and/or expecting antibiotics were associated with Veteran satisfaction with URI visits. Methods: This cross-sectional study included Veterans evaluated for URI January 2018–December 2019 in an 18-clinic ambulatory VA primary-care system. We evaluated Veteran satisfaction via the Patient Satisfaction Questionnaire Short Form (RAND Corporation), an 18-item 5-point Likert scale survey. Additional items assessed Veteran antibiotic expectations. Antibiotic receipt was determined via medical record review. We used multivariable regression to evaluate whether antibiotic receipt and/or Veteran antibiotic expectations were associated with satisfaction. Subgroup analyses focused on Veterans who accurately remembered antibiotic prescribing during their URI visit. Results: Of 1,329 eligible Veterans, 432 (33%) participated. Antibiotic receipt was not associated with differences in mean total satisfaction (adjusted score difference, 0.6 points; 95% confidence interval [CI], −2.1 to 3.3). However, mean total satisfaction was lower for Veterans expecting an antibiotic (adjusted score difference −4.4 points; 95% CI −7.2 to −1.6). Among Veterans who accurately remembered the visit and did not receive an antibiotic, those who expected an antibiotic had lower mean satisfaction scores than those who did not (unadjusted score difference, −16.6 points; 95% CI, −24.6 to −8.6). Conclusions: Veteran expectations for antibiotics, not antibiotic receipt, are associated with changes in satisfaction with outpatient URI visits. Future research should further explore patient expectations and development of patient-centered and provider-focused interventions to change patient antibiotic expectations. https://www.cambridge.org/core/product/identifier/S2732494X22002339/type/journal_article |
| spellingShingle | Milner B. Staub Rachael Pellegrino Erin Gettler Morgan C. Johnson Christianne L. Roumie Carlos G. Grijalva Kaitlyn Reasoner Robert S. Dittus Todd Hulgan Association of antibiotics with veteran visit satisfaction and antibiotic expectations for upper respiratory tract infections Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Association of antibiotics with veteran visit satisfaction and antibiotic expectations for upper respiratory tract infections |
| title_full | Association of antibiotics with veteran visit satisfaction and antibiotic expectations for upper respiratory tract infections |
| title_fullStr | Association of antibiotics with veteran visit satisfaction and antibiotic expectations for upper respiratory tract infections |
| title_full_unstemmed | Association of antibiotics with veteran visit satisfaction and antibiotic expectations for upper respiratory tract infections |
| title_short | Association of antibiotics with veteran visit satisfaction and antibiotic expectations for upper respiratory tract infections |
| title_sort | association of antibiotics with veteran visit satisfaction and antibiotic expectations for upper respiratory tract infections |
| url | https://www.cambridge.org/core/product/identifier/S2732494X22002339/type/journal_article |
| work_keys_str_mv | AT milnerbstaub associationofantibioticswithveteranvisitsatisfactionandantibioticexpectationsforupperrespiratorytractinfections AT rachaelpellegrino associationofantibioticswithveteranvisitsatisfactionandantibioticexpectationsforupperrespiratorytractinfections AT eringettler associationofantibioticswithveteranvisitsatisfactionandantibioticexpectationsforupperrespiratorytractinfections AT morgancjohnson associationofantibioticswithveteranvisitsatisfactionandantibioticexpectationsforupperrespiratorytractinfections AT christiannelroumie associationofantibioticswithveteranvisitsatisfactionandantibioticexpectationsforupperrespiratorytractinfections AT carlosggrijalva associationofantibioticswithveteranvisitsatisfactionandantibioticexpectationsforupperrespiratorytractinfections AT kaitlynreasoner associationofantibioticswithveteranvisitsatisfactionandantibioticexpectationsforupperrespiratorytractinfections AT robertsdittus associationofantibioticswithveteranvisitsatisfactionandantibioticexpectationsforupperrespiratorytractinfections AT toddhulgan associationofantibioticswithveteranvisitsatisfactionandantibioticexpectationsforupperrespiratorytractinfections |