Do general practitioners' consultation rates influence their prescribing patterns of antibiotics for acute respiratory tract infections?

Gjelstad, Svein; Straand, Jørúnd; Dalen, Ingvild; Fetveit, Arne; Strøm, Hanne; Lindbæk, Morten

doi:10.1093/jac/dkr295

Cited by 84 publications

(97 citation statements)

References 19 publications

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“…No significant differences in their prescribing practice were revealed. 37 Therefore, the authors believe that the participating GPs were fairly representative of the Norwegian population of GPs in general. Using GPs as PADs possibly had a positive effect on both GPs' participation and their perceptions of the relevance of the intervention.…”

Section: Strengths and Limitationsmentioning

confidence: 96%

Prescription peer academic detailing to reduce inappropriate prescribing for older patients: a cluster randomised controlled trial

Rognstad¹,

Brekke²,

Fetveit³

et al. 2013

Br J Gen Pract

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BackgroundOlder patients are at particular risk for adverse drug reactions. In older people, interventions targeting potentially inappropriate prescriptions (PIPs) are considered important measures to minimise drug-related harm, especially in the general practice setting where most prescriptions for older patients are issued. AimTo study the effects of a multifaceted educational intervention on GPs' PIPs for older patients. Design and settingThis was a cluster randomised, educational intervention study in Norwegian general practice. Pre-study data were captured from January 2005 MethodEighty continuing medical education (CME) groups (465 GPs) were randomised to receive the educational intervention on GPs' PIPs for older patients (41 CME groups; 256 GPs) or another educational intervention (39 CME groups; 209 GPs); these two groups acted as controls for each other. GPs' prescription data from before and after the intervention were assessed against a list of 13 explicit PIP criteria for patients aged ≥70 years. In the CME groups, trained GPs carried out an educational programme, including an audit, focusing on the 13 criteria and their rationale. ResultsA total of 449 GPs (96.6%) completed the study; 250 in the intervention group and 199 in the control group. After adjusting for baseline differences and clustering effects, a reduction relative to baseline of 10.3% (95% confidence interval = 5.9 to 15.0) PIPs per 100 patients aged ≥70 years was obtained. ConclusionEducational outreach visits with feedback and audit, using GPs as academic detailers in GPs' CME groups, reduced PIPs for older patients aged ≥70 years in general practice.

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Section: Strengths and Limitationsmentioning

confidence: 96%

Prescription peer academic detailing to reduce inappropriate prescribing for older patients: a cluster randomised controlled trial

Rognstad¹,

Brekke²,

Fetveit³

et al. 2013

Br J Gen Pract

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“…One study found that patients were equally satisfied whether or not they received antibiotics (7), but it takes more time not to prescribe. Indeed, a correlation has been shown between a busy doctor and a higher prescription rate (2).…”

Section: Discussionmentioning

confidence: 99%

En ungdom med luftveisplager og kortvarig feber

Loose¹,

Elde²,

Aune³

et al. 2015

Tidsskriftet

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Choice of treatment can be challenging in the casualty clinic. Early in the disease course in particular, clinical signs can be sparse and diagnostic tools limited. Sometimes the road to ruin is paved with good intentions. Symptoms of a respiratory tract infection are among the most common reasons for attendance at GP surgeries and casualty clinics. In the current case, a viral upper respiratory tract infection is a likely diagnosis, while infection-triggered obstructive pulmonary disease, pneumonia and influenza are possible differential diagnoses. It was not influenza season, but there was an ongoing mycoplasma epidemic. Symptoms of atypical pneumonia are a long-lasting severe dry cough, sore throat and headache, but the patient had neither a cough nor a sore throat. A boy in his earlyRarer differential diagnoses were considered unlikely. He had a low risk of pulmonary embolism and no stabbing pains upon inspiration. The absence of pain also made pneumothorax and pleuritis unlikely. In addition, he had similar respiratory sounds on both sides. With tuberculosis we would have expected a cough, which he did not have. He had no heart problems and there was no suspicion of heart failure. Bronchitis and pneumonia are frequent causes of shortness of breath. Bronchitis is chiefly attributable to viruses, while pneumonia in adults is usually caused by bacteria. The most common agents outside hospitals are Streptococcus pneumoniae, followed by Chlamydophila pneumoniae and viruses, as well as M. pneumoniae during epidemics every few years. In children over three months, the aetiology is reversed, with viruses the most common agents. Bacteria are the main cause in the very young.

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“…14 This coincides with lower levels of antibiotic resistance in the Scandinavian countries in general, 23 probably as a result of more restrictive prescription patterns. It is likely that there would be a benefit in decreasing the use of macrolides during M. pneumoniae epidemics to prevent the emergence of resistant strains.…”

mentioning

confidence: 90%

Mycoplasma pneumoniaedetection causes excess antibiotic use in Norwegian general practice: a retrospective case–control study

Foshaug¹,

Vandbakk-Rüther

Skaare

et al. 2015

Br J Gen Pract

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Do general practitioners' consultation rates influence their prescribing patterns of antibiotics for acute respiratory tract infections?

Cited by 84 publications

References 19 publications

Prescription peer academic detailing to reduce inappropriate prescribing for older patients: a cluster randomised controlled trial

Prescription peer academic detailing to reduce inappropriate prescribing for older patients: a cluster randomised controlled trial

En ungdom med luftveisplager og kortvarig feber

Mycoplasma pneumoniaedetection causes excess antibiotic use in Norwegian general practice: a retrospective case–control study

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