Talking with patients about infections

Experience from general practice shows that some patients expect an antibiotic for themselves or their child and that a viral illness diagnosis or a non-antibiotic treatment recommendation may initially be questioned. Alongside this there is good evidence that many patients are satisfied if they are listened to carefully, examined thoroughly where this is needed and provided with a reasoned explanation as to why an antibiotic may not be required with alternatives recommended for relieving symptoms. 

Studies show there is often a mismatch between what the GP thinks the patient is demanding and what the patient really wants. This mismatch may also occur in consultations with pharmacists and is an issue that should be explored. 

A useful way of thinking about conversations with patients is the 3E’s: Empathise, Evaluate, Educate. The UK Health Security Agency (UKHSA) and Royal College of General Practitioners developed a consultation structure with the acronym  as part of the TARGET toolkit.

CHESTSSS can help you to remember specific phrases which reassure patients, increase patient understanding and satisfaction with a prescribing decision, avoid reconsultations and may be particularly helpful for patients who are expecting antibiotics. Table 3 suggests some phrases that might be useful. The Pharmacy First CPD modules currently running in Pharmacy Magazine tailor the suggested phrases to different conditions.