// ARS TECHNICA — SALUTE
Over 25% of people lie to get antibiotics—and their lies aren't even good
Faked symptoms still point to infections that antibiotics don’t treat.
A significant number of patients in the US lie to their doctors to get antibiotics they likely don’t need, according to two new studies. While that may not be a startling revelation, the studies drills down on the phenomenon, finding that the lies patients tell are generally bad ones—and yet, they work almost all the time.
In the two linked studies published Friday in JAMA Network Open, a team of researchers led by Alistair Thorpe at the University of Utah analyzed online survey data from over 1,000 adults. They found that over a quarter of people reported having lied to a clinician at least once to get an antibiotic prescription for themselves or a child in their care. Patients lied by either exaggerating symptoms, making up symptoms, or—most often—both.
But interestingly, the lies people told to get antibiotics involved making up or exaggerating symptoms of infections that wouldn’t be treated with antibiotics. For example, the most common falsehoods were symptoms associated with colds, such as fever, cough, and sore throat. That’s despite the fact that colds are caused by viruses, not bacteria—which antibiotics treat.
Further, while the data suggests many patients were being dishonest, clinicians responded with what could be considered their own form of dishonesty; in most cases, the dubious fibs led to antibiotic prescriptions. Specifically, 77 percent of adult patients and 87 percent of caregivers said their lies worked, leading them to get the antibiotic prescriptions they wanted.
“These findings signal a significant issue for health professionals making antibiotic prescribing decisions and for the fields of antimicrobial stewardship and public health,” Thorpe and colleagues concluded.
For the study, the researchers reviewed survey responses from 1,371 online respondents and found 959 responses that were valid and complete. Of those, 268 (28 percent) respondents reported misrepresenting their symptoms to get antibiotics. Of those, 108 reported exaggerating symptoms, 19 reported fabricating symptoms, and 141 reported doing both. In a separate analysis of 263 respondents who identified as caregivers, 63 (27 percent) reported misrepresenting symptoms of a child to get antibiotics.
The most common reported reasons for lying were that people: felt their illness or the illness of a child in their care was particularly severe; believed that antibiotics were the only thing that would help them; believed antibiotics would help them return to responsibilities (work/school) faster; or felt they should have personal autonomy (thinking they know more about their health status than the clinician or feeling like they should get to decide their own treatment).
Those who misrepresented their symptoms tended to be younger and feel their symptoms were not taken seriously by clinicians. They were more likely to believe that antibiotic resistance is a hoax, such as a scare tactic by the government or a gimmick by drug companies to justify charging more for antibiotics. People who lied were also more likely to have more underlying conditions, view lying as more acceptable, and report needing help reading health-related materials. On the other hand, those who didn’t report misrepresenting their symptoms tended to have greater antibiotic knowledge and aversion to taking antibiotics.
For people who reported misrepresenting symptoms, the online survey gave them additional questions about the types of symptoms they fabricated or exaggerated. The most common falsehoods, reported by 65 percent of dishonest patients, were to misrepresent cold-related symptoms. After that were misrepresented stomach symptoms (49 percent), joint or muscle pain (46 percent), eye symptoms (34 percent), rashes and other skin conditions (32.5 percent), urinary symptoms (31 percent), or a general feeling of being unwell (37 percent). Respondents could also report not remembering what they lied ab