02 juin 2022

Association between clinician distress and inappropriate use of antibiotic prescriptions

The overprescribing of antibiotics in U.S. outpatient settings is an urgent public health concern. The majority of these antibiotic prescriptions are written for acute respiratory tract infections (RTIs), even though antibiotics are inappropriate for treating viral RTIs such as bronchitis, sore throats, common colds and the flu. A new study from the May 2022 issue of The Joint Commission journal on quality and patient safety, Clinician distress and inappropriate antibiotic prescribing for acute respiratory tract infections: a retrospective cohort study, examined the association between clinician distress and the inappropriate use of antibiotic prescriptions for acute RTIs in adult outpatients.

The researchers evaluated electronic health record visit data linked to annual wellness surveys administered to all clinicians at Boston Medical Center, Boston. Outpatient visits included those in family medicine, general internal medicine and the emergency department where an acute RTI for an otherwise healthy adult was listed as a primary diagnosis. Clinician depression, anxiety and burnout were assessed using the National Institute of Health patient report outcomes measurement information system and the Stanford professional fulfillment index burnout composite scale obtained from clinician wellness survey data collected up to six months prior to a patient visit.

Overall, approximately 34% and 50% of clinicians in the study reported depression/anxiety and burnout symptoms, respectively. Findings showed each one standard deviation increase in a clinician’s composite depression and anxiety score was associated with a 28% increase in the odds of an inappropriate antibiotic prescription for an acute RTI. Clinician burnout had no significant association with inappropriate antibiotic prescribing.