Physicians’ views and knowledge on the antibiotic treatment of pneumonia in advanced dementia

Itai Harpaz, Boris Punchik, Tamar Freud, Yan Press

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Antibiotic treatment (AT) for patients with advanced dementia and pneumonia is a complex issue. AT can prolong life, but it can also prolong suffering for the patient and the family. In this study we evaluated physicians’ attitudes to this issue. Methods: A vignette-based survey among community-based physicians (CBP) and hospital-based physicians (HBP) who work in southern Israel. The physicians were asked to complete a questionnaire on their knowledge and attitudes to AT, based on a case description of a patient with advanced dementia and pneumonia. Results: 211 physicians participated in the study including 134 CBP (63.5%) and 77 HBP (36.5%). 177 physicians chose the AT option for the patient presented in the case, with 59.7% of the HBP and 32.8% of the CBP choosing intravenous (IV) AT (p = 0.017). In contrast, in the same case, but with themselves as the patient, 68.8% of HBP and 32.8% of CBP chose the option of palliative care without AT, with only 14.3% of HBP and 10.4% of CBP choosing the option of hospitalization with IV AT. In two logistic regression models, physicians who chose IV AT for themselves were fourfold more likely to make a similar choice for their patients. Over 75% of the physicians were not knowledgeable about the administration of AT in accordance with the Dying Patient Act. Conclusions: The results of this study indicate the need for an educational intervention among physicians to expand their knowledge and expertise on end-of-life treatment for patients with advanced dementia. In addition, we invite policy makers to convene a discussion on the possibility of changing the law to facilitate the conduct of studies of patients with advanced dementia. Such studies would make it possible to develop an evidence-based treatment strategy.

Original languageEnglish
Article number61
JournalIsrael Journal of Health Policy Research
Volume13
Issue number1
DOIs
StatePublished - 1 Dec 2024

Keywords

  • Advance dementia
  • Antibiotic treatment
  • Physicians
  • Pneumonia

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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