How patients' experiences of respiratory tract infections affect healthcare-seeking and antibiotic use: insights from a cross-sectional survey in rural Anhui, China

BMJ Open. 2018 Feb 3;8(2):e019492. doi: 10.1136/bmjopen-2017-019492.

Abstract

Objective: To investigate the occurrence of reported respiratory tract infection (RTI) symptoms and their effects on use of self and professional care among patients in the community.

Design: A cross-sectional retrospective household survey.

Setting: 12 administrative villages from rural Anhui, China.

Participants: 2160 rural adult residents aged ≥18 years registered as rural residents and actually living in the sampled villages when this study was conducted.

Method: The respondents were recruited using stratified-clustered randomised sampling. A structured questionnaire was deployed to solicit information about social demographics, symptoms of last RTI and healthcare-seeking following the RTI. Descriptive analyses were performed to investigate the reported symptoms, and multivariate logistic regression models were developed to identify relationships between number of concurrent symptoms and healthcare-seeking and antibiotics use.

Results: A total of 1968 residents completed the survey, resulting in a response rate of 91.1%. The number of concurrent symptoms showed a clear increasing trend with seeking help from clinics and being prescribed antibiotics. Multivariate regression revealed statistically significant associations between the following: (a) visiting clinics and education (OR=0.790), sore throat (OR=1.355), cough (OR=1.492), shortness of breath (OR=1.707) and fever (OR=2.142); (b) buying medicine from shops without prescription and education (OR=1.230) and cough (OR=1.452); (c) getting antibiotics at clinics and sore throat (OR=2.05) and earache and/or tinnitus (OR=4.884); and (d) obtaining antibiotics at medicine shops and productive cough (OR=1.971).

Conclusions: Reported RTI symptoms play an important role in shaping both patient- and doctor-led responses.

Keywords: antibiotics; healthcare-seeking; respiratory tract infection; rural residents.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • China
  • Cough / drug therapy
  • Cross-Sectional Studies
  • Female
  • Fever / drug therapy
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Pharyngitis / drug therapy
  • Respiratory Tract Infections / drug therapy*
  • Respiratory Tract Infections / physiopathology*
  • Retrospective Studies
  • Rural Population
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Anti-Bacterial Agents