ArticleBMC primary care2025
General practitioners' antibiotic prescribing decisions in the Northern Dutch-German cross-border region: a discrete choice experiment.
Article in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundRedundant antibiotic (ABX) use unnecessarily contributes to antimicrobial resistance, complicating infection treatment. ABX prescription rates are higher in Germany than in the Netherlands, with increasing rates near the Dutch-German border. The reason for this remains unclear. Most ABXs are prescribed in primary care, particularly for upper respiratory tract infections (URTIs). Understanding the determinants influencing general practitioners (GPs) prescribing behaviors is crucial for developing targeted interventions. This study assessed how subjective and objective determinants influence GPs' ABX prescription for URTIs, extending and quantifying the results of our previous qualitative study.
methodsABX prescribing decisions were analyzed through a discrete choice experiment (DCE). The DCE consisted of eight choice tasks, each depicting two fictional scenarios described by six attributes. Based on our prior qualitative study, the attributes assessed were the effects of time constraints, patient pressure, language proficiency, C-reactive protein (CRP) levels, comorbidity, and clinical presentation (fever) on GPs' decisions to prescribe ABX for URTIs. Participants chose the scenario where ABX prescription was deemed most appropriate. The choices for the preferred vignette were regressed on the attributes using a conditional logit model.
resultsFrom mid-July to mid-September 2024, 47 GPs practicing in the Dutch-German 'Ems-Dollart' border region (n = 19 on the German side and n = 28 on the Dutch side) consented to and completed an online survey. In this DCE, a higher CRP level (40 mg/L) significantly increased the likelihood of intended ABX prescribing for URTIs compared to the reference category of 10 mg/L (OR 6.13, 95% CI 4.20-8.94). Similarly, the presence of a comorbidity (type II diabetes) (OR 2.78, 95% CI 1.91-4.05) and having fever as clinical presentation (OR 2.07, 95% CI 1.42-3.02), also significantly raised the likelihood of hypothetical ABX prescribing compared to their respective reference categories, (no diabetes and no fever). Conversely, patient pressure, time constraints and language barriers showed weak, non-significant associations. CRP had the highest relative importance (47%), followed by comorbidity (26%) and clinical presentation (19%), while non-clinical factors had less than 5% importance in decision-making.
conclusionsOur study demonstrated that clinical factors play a significant role in intended ABX prescribing decision-making compared to non-clinical factors.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.