Parents’ Expectation to Receive Antibiotic Prescription for Children

Background: The Centers for Disease Control indicated that in 2009, 90 million prescriptions were written for antibiotics in the United States, with half of those being "unnecessary or inappropriate". The highest rate of antibiotic use was evident in children younger than 15 years old. Physician’s perception of parents’ expectation to receive antibiotic prescription for their children is a significant predictor of overprescribing antibiotics. Objective: The objective was to manipulate two factors (parents’ ‘perceived benefits of using antibiotics’ and their ‘perceived barriers to visit doctors without any expectation of antibiotic prescription’) and then evaluate whether their level of expectation would change after the manipulation. Methods: A prospective experimental study was conducted using a structured data collection instrument. The purpose of the experiment was to manipulate two variables, perceived barriers and perceived benefits using four scenarios and keep other factors constant. Each subject viewed four situations and expectation associated with each situation was evaluated. Subjects who had at least one child (age ≤ 5 years) during the study and who could speak, read and write English were selected for the study. Data were collected at shopping malls and parks in Houston, TX. Descriptive analyses and repeated measures mixed method covariance adjusted analyses were performed using SAS® 9.3. The a-priori significance level was set as 0.05 for all tests conducted. Results: A total of 300 complete surveys were considered for analyses. The mean age for the sample was 30.36 (± 7.04) years; females represented 55.7% of the sample. The mean general expectation score (before reading any scenario) to receive antibiotic prescription for children was 53.6 (± 25.7). The repeated measure mixed methods analyses indicated that there was 12 point reduction (p < 0.0001) in expectation score after removing perceived barriers from the situational scenarios. Almost 16 point decrease (p < 0.0001) in expectation score was observed after removing perceived benefits from the scenario. There was 18 point decrease (p < 0.0001) in expectation score after removing perceived barriers and perceived benefits from the situational scenario. The study result also indicated that general expectation toward an antibiotic prescription, training in the healthcare field and parents’ preference for communication had significant effect on parents’ expectation. Conclusions: Perceived barriers, perceived benefits alone and in combination have effect on parents’ expectation to receive antibiotic prescription for children. Policy makers as well as intervention programs should consider these factors to enhance successful reduction of antibiotic expectations.Pharmacy, College o