Reducing Parental Demand for Antibiotics by Promoting Communication Skills

Antibiotic-resistant strains of bacteria are continuing to emerge as high rates of antibiotic use persist. Children are among the highest users of antibiotics, with parents influencing physician decision-making regarding antibiotic prescription. An intervention based on Social Cognitive Theory (SCT) to reduce parents' expectations for antibiotics in favor of communication with the physician was tested. A randomized factorial design study was conducted testing a communication skills intervention against an information-based intervention, a combined intervention and a control condition. Parents receiving the communication skills intervention reported higher efficacy to communicate with the physician (p = 0.021). Interaction between the communication skills and information interventions was observed for specific treatment expectations prior to the visit (p = 0.049). The communication skills intervention was protective against antibiotic prescribing (p = 0.042). Satisfaction was positively associated with parents' efficacy to communicate (p = 0.002) and when an antibiotic was not prescribed (p = 0.005). Interventions using information to reduce antibiotic use may be based on the false assumption that such approaches are sufficient for motivating appropriate health practices. Using demonstrated behavior change approaches to promote communication behaviors by parents might result in the dual benefits of reducing unwarranted antibiotic use and improving satisfaction with the clinic visit.