Controlled Trials to Improve Antibiotic Utilization: A Systematic Review of Experience, 1984–2004

Parrino, Thomas A.

doi:10.1592/phco.25.2.289.56951

Cited by 25 publications

(10 citation statements)

References 64 publications

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“…Multiple interventions can be divided into managerial approaches alongside educational interventions (20). Managerial interventions include computerized decision support systems, prescribing indicators, community case management programmes, formulary restrictions and prior authorisations (19,20,25,79). The added influence of multiple interventions alongside educational activities to favourably influence physician prescribing has also been shown in other disease areas with interventions including indicators, financial incentives to all key stakeholder groups and prescribing restrictions (80)(81)(82)(83).…”

Section:  Knowledge Among Physicians Regarding Antibiotics and Antibmentioning

confidence: 99%

Physicians’ knowledge, perceptions and behaviour towards antibiotic prescribing: a systematic review of the literature

Rezal

Hassali

Alrasheedy

et al. 2015

Expert Review of Anti-infective Therapy

173

192

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Background: Knowledge, perceptions and prescribing behaviour are key to antibiotic prescribing. The aim of this paper is to systematically review this. Method: An extensive literature search from 1990-2014. Results: 19 articles were included; 8 in ambulatory care, 7 in hospital settings, and 4 in both, across all countries. Physicians still have inadequate knowledge and misconceptions about antibiotic prescribing. Moreover, some physicians although aware that antibiotics are of limited benefit in some conditions still prescribed them. Several factors influenced prescribing including patients' expectations, severity and duration of infections, uncertainty over diagnosis, potentially losing patients, and influence of pharmaceutical companies. Pocket-sized guidelines seen as an important source of information for physicians. Conclusion: Inadequate knowledge of prescribing is prevalent among physicians. However, many physicians were interested in improving their antibiotic prescribing. Multifaceted interventions targeting all key stakeholders including patients are needed to improve future antibiotic prescribing.

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Section:  Knowledge Among Physicians Regarding Antibiotics and Antibmentioning

confidence: 99%

Physicians’ knowledge, perceptions and behaviour towards antibiotic prescribing: a systematic review of the literature

Rezal

Hassali

Alrasheedy

et al. 2015

Expert Review of Anti-infective Therapy

173

192

View full text Add to dashboard Cite

show abstract

“…Such strategies may include formulary lists, authorization of prescriptions containing certain medicines and reminders to use certain medicines rather than others during the prescribing process (previously mentioned as being effective). A systematic review of controlled trials during 1984-2004 to improve antibiotic use found that administrative methods, including authorization of use by automatic or mandatory consultations, computer-based authorization systems and formulary restrictions, were effective in improving antibiotic use and reducing overuse and costs [42]. Computerized clinical decision-support systems are used widely in developed countries and have been found to be effective in improving the initiation and monitoring of drug treatment [43].…”

Section: Administrative and Managerial Strategies To Support Decision-mmentioning

confidence: 99%

Combating inappropriate use of medicines

Holloway

2011

Expert Review of Clinical Pharmacology

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Globally, it is possible that less than half of all patients are treated in compliance with guidelines and more than half of all patients fail to take their medicines as prescribed or dispensed. Such inappropriate use is wasteful of resources and causes patient harm in terms of lack of satisfactory outcome, serious adverse events and increased antimicrobial resistance. Combating inappropriate use of medicines involves four major steps: measuring the use of medicines; identifying the determinants of inappropriate use; developing, implementing and evaluating the impact of interventions to improve the use of medicines while taking into account the factors underlying inappropriate use; and working towards an enabling policy framework that encourages appropriate use. Global evidence on how to effectively combat inappropriate use of medicines is discussed herein, with reference to the aforementioned four steps. Most interventions undertaken to combat inappropriate use of medicines have been educational in nature, have had a relatively small impact and have not taken into account the determinants of behavior. A combination of interventions, involving managerial as well as educational components, appears to be more effective than a single intervention. Less than half of countries have a policy framework that actively encourages appropriate use of medicines. Since health systems are varied and complex, a nationally coordinated package of interventions and policies, contextualized to each country, will be needed to have any substantial impact on medicine use. There is now increasing global awareness of the need to strengthen health systems, to have national coordination to combat inappropriate use of medicines and to have coordination of international aid to developing countries in order to ensure it contributes to combating inappropriate use of medicines. The opportunities this presents for combating inappropriate use of medicines are discussed in this article.

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“…These articles were identified by searching MEDLINE for the keywords "antibiotic," "resistance" and "utilization," and by screening the results for articles that focused on interventions in entire populations rather than individual institutions Reductions in antibiotic use through such programs, although measurable, are modest, [45][46][47][48][49][50] One review concluded that there was some benefit from social marketing, practice guidelines, authorization systems and peer review with feedback, and speculated that online systems that provide clinical information, structured order entry, and decision support may be the most promising approach. 51 A book developed as part of the "Do Bugs Need Drugs?" program in British Columbia and Alberta represent important initiatives to create understanding among doctors and patients about the importance of reducing antimicrobial misuse.…”

Section: Physicians and The Regulation Of Antibioticsmentioning

confidence: 99%

Antibiotic use and population ecology: How you can reduce your "resistance footprint"

Patrick¹,

Hutchinson²

2009

Canadian Medical Association Journal

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Controlled Trials to Improve Antibiotic Utilization: A Systematic Review of Experience, 1984–2004

Cited by 25 publications

References 64 publications

Physicians’ knowledge, perceptions and behaviour towards antibiotic prescribing: a systematic review of the literature

Physicians’ knowledge, perceptions and behaviour towards antibiotic prescribing: a systematic review of the literature

Combating inappropriate use of medicines

Antibiotic use and population ecology: How you can reduce your "resistance footprint"

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