83 Determinants of inappropriate antibiotic prescription in primary care in developed countries with general practitioners as gatekeepers 3 Framework Culture of healthcare consumption Patient factors and experiences Culture of professional medicine Clinician attitudes and beliefs Practice environment The patient-clinician interaction More signs of inflammation (fever etc) GP’s judgement of more severe illness GP’s perception of high patient expectation for antibiotic Age of patient younger than 24 months GP’s judgement of more severe illness GP’s perception of high patient expectation for antibiotic No access to guidelines due to high cost Patients expect an antibiotic due to past experience and have high expectations of antibiotics Access to guidelines during consult is timeconsuming Medical education outside Canada or United States More years in practice Higher practice volume Severity of illness at first contact Feeling how one should perform Habit Disease behaviour of the patient To ease the patient Request by patient Co-morbidity Negative events in the past GP’s perception of high patient expectation for antibiotic Young age (less than 2 years) Belongs to risk group Many other non-medical problems presented Impact of disease on patient
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