Abstract
BackgroundPatient gender as well as doctor gender are known to affect doctor-patient interaction during a medical consultation. It is however not known whether an interaction of gender influences antibiotic prescribing. This study examined GP’s prescribing behavior of antibiotics at the first presentation of patients with sore throat symptoms in primary care. We investigated whether GP gender, patient gender and gender concordance have an effect on the GP’s prescribing behavior of antibiotics in protocolled and non-protocolled diagnoses.MethodsWe analyzed electronic health record data of 11,285 GP practice consultations in the Netherlands in 2013 extracted from the Nivel Primary Care Database. Our primary outcome was the prescription of antibiotics for throat symptoms. Sore throat symptoms were split up in ‘protocolled diagnoses’ and ‘non-protocolled diagnoses’. The association between gender concordance and antibiotic prescription was estimated with multilevel regression models that controlled for patient age and comorbidity.ResultsAntibiotic prescription was found to be lower among female GPs (OR 0.88, CI 95% 0.67–1.09; p = .265) and female patients (OR 0.93, 95% 0.84–1.02; p = .142), but observed differences were not statistically significant. The difference in prescription rates by gender concordance were small and not statistically significant in non-protocolled consultations (OR 0.92, OR 95% CI: 0.83–1.01; p = .099), protocolled consultations (OR 1.00, OR 95% CI: 0.68–1.32; p = .996) and all GP practice consultations together (OR 0.92, OR 95% CI: 0.82–1.02; p = .118). Within the female GP group, however, gender concordance was associated with reduced prescribing of antibiotics (OR 0.85, OR 95% CI: 0.72–0.99; p = 0.034).ConclusionsIn this study, female GPs prescribed antibiotics less often than male GPs, especially in consultation with female patients. This study shows that, in spite of clinical guidelines, gender interaction may influence the prescription of antibiotics with sore throat symptoms.
Highlights
Patient gender as well as doctor gender are known to affect doctor-patient interaction during a medical consultation
Data source The electronic health records for this study were provided by the Netherlands Institute for Health Services Research (Nivel) Primary Care Database, containing General Practitioner (GP) practice consultations from 2013
This study focuses on International classification of primary care (ICPC) codes relating to sore throat symptoms
Summary
Patient gender as well as doctor gender are known to affect doctor-patient interaction during a medical consultation. Growing microbacterial resistance is partly a natural process, it can be accelerated with the inappropriate prescription of antibiotics by health care professionals [2]. With this in mind, factors which influence. Female patients are more likely to express their emotions during the consultation [14] and had fewer discussions about addictive behavior or heart disease risk [9, 15] This implies that GPs might make medical decisions which are affected by gender-related considerations and gender stereotypes
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