Joint Commission study: Likelihood of clinicians overprescribing antibiotics when distressed

Editor's Note

In this study, titled “Clinician Distress and Inappropriate Antibiotic Prescribing for Acute Respiratory Tract Infections [RTIs]: A Retrospective Cohort Study” and published in the May 2022 issue of The Joint Commission Journal on Quality and Patient Safety, the researchers examined the association between clinician distress and the inappropriate prescription of antibiotics for acute RTIs in adult outpatients.

The study’s premise is the public health concern of clinicians overprescribing antibiotics in outpatient settings as treatment for acute RTIs, even though “antibiotics are inappropriate for treating viral RTIs such as bronchitis, sore throats, common colds, and the flu.” The researchers evaluated electronic health record data linked to annual wellness surveys administered to all clinicians at Boston Medical Center, Massachusetts, for outpatient visits where an acute RTI for an otherwise healthy adult was listed as a primary diagnosis.

Here are the findings:

• Approximately 34% of clinicians in the study reported depression/anxiety symptoms.
• One standard deviation increase in a clinician’s composite depression/anxiety score was associated with a 28% increase in the odds of an inappropriate antibiotic prescription for an acute RTI.
• Approximately 50% of clinicians in the study reported burnout symptoms.
• Clinician burnout had no significant association with inappropriate antibiotic prescribing.

This study was conducted pre-pandemic, The Joint Commission news release noted.