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Reducing antibiotic prescriptions for respiratory tract infections in family practice: results of a cluster randomized controlled trial evaluating a multifaceted peer-group-based intervention

Overview of attention for article published in npj Primary Care Respiratory Medicine, February 2016
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Title
Reducing antibiotic prescriptions for respiratory tract infections in family practice: results of a cluster randomized controlled trial evaluating a multifaceted peer-group-based intervention
Published in
npj Primary Care Respiratory Medicine, February 2016
DOI 10.1038/npjpcrm.2015.83
Pubmed ID
Authors

Marcia Vervloet, Marianne A Meulepas, Jochen W L Cals, Mariëtta Eimers, Lucas S van der Hoek, Liset van Dijk

Abstract

Irrational antibiotic use for respiratory tract infections (RTI) is a major driver of bacterial resistance. The aim of this study was to evaluate the effect of a multifaceted peer-group based intervention aiming to reduce RTI-related antibiotic prescriptions in family practice. This was a cluster randomized controlled trial with pre- and follow-up measurement. The intervention was implemented through PharmacoTherapy Audit Meetings (PTAM) in which family physicians (FPs) and pharmacists collaborate. Four PTAM groups received the intervention consisting of: (1) FP communication skills training, including communication about delayed prescribing; (2) implementation of antibiotic prescribing agreements in FPs' Electronic Prescribing Systems; (3) quarterly feedback figures for FPs. Four other PTAM groups were matched controls. Primary outcome measure was the number of RTI-related antibiotic prescriptions after the intervention, assessed with multilevel linear regression analyses. Total number and number of prescriptions stratified by age (under/over 12 years) were analysed. At baseline, the average total number of RTI-related antibiotic prescriptions per 1,000 patients was 207.9 and 176.7 in the intervention and control PTAM groups, respectively. At follow-up, FPs in both the intervention and control groups prescribed significantly less antibiotics. For adolescents and adults, the drop in number of antibiotic prescription was significantly larger in the intervention groups (-27.8 per 1,000 patients) than the control groups (-7.2 per 1,000 patients; P<0.05). This multifaceted peer-group-based intervention was effective in reducing the number of RTI-related antibiotic prescriptions for adolescents and adults. To affect antibiotic prescribing in children other methods are needed.

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Geographical breakdown

Country Count As %
United Kingdom 1 <1%
Brazil 1 <1%
Unknown 137 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 28 20%
Researcher 21 15%
Student > Ph. D. Student 17 12%
Student > Bachelor 15 11%
Other 9 6%
Other 22 16%
Unknown 27 19%
Readers by discipline Count As %
Medicine and Dentistry 46 33%
Pharmacology, Toxicology and Pharmaceutical Science 15 11%
Nursing and Health Professions 13 9%
Psychology 10 7%
Social Sciences 7 5%
Other 16 12%
Unknown 32 23%