"As clinicians, we know that patients lie to us sometimes," Dr. Jeffrey Linder, a general internist and primary care clinician-investigator at Northwestern Medicine, wrote in a commentary about the survey findings.
A major factor driving resistance among bacteria is the misuse of antibiotics — in other words, using antibiotics for ailments like viral infections, which the drugs do not treat. For individual patients, such prescriptions don't cure their illness and can result in an upset stomach or issues with the gut microbiome, the community of microbes in the intestines. Simultaneously, they place extra pressure on bacteria to evolve resistance, granting the germs opportunities to pick up new strategies for thwarting antibiotics.
The new surveys were published Friday (Oct. 30) in the journal JAMA Network Open.
Overall, about 28% of the respondents reported misrepresenting their symptoms, including 26% who exaggerated their existing symptoms and 17% who fabricated symptoms. They most frequently lied about cold-like symptoms, such as fever, cough and sore throat. About two-thirds of these patients were at least moderately confident that their lie would motivate a clinician to prescribe them antibiotics, and 77% said the strategy worked for them at least once.
"Greater antibiotic knowledge and aversion to taking antibiotics were associated with lower odds of misrepresentation," meaning lying about symptoms, the study authors noted.
The second survey was much smaller; it included 236 parents and other guardians of children and teens under 18 years old. It posed similar questions but asked whether the caregivers had lied about their children's symptoms and, if so, what motivated them to lie.
"These findings suggest that symptom misrepresentation may contribute to antibiotic overuse in pediatric care," the study authors concluded.
Ideally, antibiotics should be used only when truly needed, to help relieve the pressure on bacteria to gain resistance. (Image credit: CDC/ Melissa Dankel)Doctors are still the gatekeepers
Especially in outpatient settings, which account for most antibiotic use among U.S. patients, it can be difficult for doctors to quickly determine whether a patient needs an antibiotic.
But in the face of these pressures and patients' occasional lies, Linder argues that it's still up to the clinicians to do the right thing. "While clinicians might interpret patients' symptom maximization and questions as demands for antibiotics, symptoms do not determine the indication, a diagnosis does," he wrote in the commentary.
Related stories"It does not track that approximately 80% of respondents who reported misrepresenting their symptoms obtained a prescription," he added, "unless prescribers were being willfully deceived or, more likely, just getting worn down with what they perceive as patient demand, regardless of actual clinical appropriateness."
"Clinicians' obligation is to act in patients' best interest," he said, "even if patients are hoping we do something different, even if patients do not like it, or even if patients lie about their symptoms."
This article is for informational purposes only and is not meant to offer medical advice.
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