Patient-related Factors to Antibiotics Overuse in China: Self-medication, Desire of Antibiotics, and use of IV Drip

• In Event: 366 - Open Refereed Roundtable Session II
  In Refereed Roundtable: B. Table 22. Medical/Health I

Abstract

OBJECTIVE
What contribute to China’s rampant antibiotics overuse problem? We argued that patient behavioral factors such as self-medication, and having desire of antibiotic prescriptions play an important role.

METHODS
A cross-sectional survey study on children’s most recent medical visit for cold-like symptoms was conducted in 21 provinces in China in 2013. A multi-stage sampling strategy was used. 3343 parents of children between 3-10 years old participated, and 3163 questionnaires were entered for analysis.

RESULTS
73% respondents reported that they have medicated their child before they visited doctor; among them 54% used antibiotics. Of the 44% respondents who reported having medication-related desires before they visited doctor, 56% reported having desires of antibiotic prescriptions. A 68 percent of parents reported they received antibiotic prescriptions for the visit; among them, 54% received oral agents, while 64% received Intravenous drip antibiotics. Furthermore, doctors fulfilled these desires very frequently, in 87% of the cases. Parents who live in less urban areas, having child of older age, with lower education attainment are more likely to self-medicate their child with antibiotics. Besides, parents being male and living in tier-3 urban areas (approximate to rural areas) are most likely to desire antibiotic prescriptions, especially IV antibiotics.

CONCLUSIONS
Although distorted financial incentives for physicians has been mostly discussed in the existing literature, we found that patient behavioral factors such as self-medication and desire of antibiotic prescriptions also contribute to China’s antibiotics overuse problem. Intervention programs addressing patient health behavior and misconception regarding antibiotics are recommended.

Authors

• Nan Wang, University of California-Los Angeles

• Tanya Stivers, University of California-Los Angeles

• John Heritage, University of California-Los Angeles