Effect of educational outreach on general practice prescribing of antibiotics and antidepressants: A two-year randomised controlled trial

Enriquez-puga, Andres; Baker, Richard; Paul, Sanjoy K.; Villoro, Renata

doi:10.3109/02813430903226530

Cited by 19 publications

(35 citation statements)

References 14 publications

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“…In primary care (table 2 ), 33 studies (70%) [ 20 – 24 , 26 , 27 , 29 , 30 , 32 – 39 , 41 , 44 , 45 , 47 , 48 , 50 , 51 , 53 , 54 , 56 , 58 – 61 , 63 , 65 ] focused on the use of antibiotics in respiratory infections, and one focused on the use of antibiotics in infectious diseases and other infections (urinary infections, skin and soft tissue infections and septicemia) [ 27 ]; the remaining 30% failed to identify any target disease [ 25 , 28 , 31 , 40 , 42 , 43 , 46 , 49 , 52 , 55 , 57 , 62 , 64 , 66 ]. Of the 47 papers, 27 (57%) studied the efficacy/effectiveness of one or more interventions versus non-intervention, using a control group that received the intervention in four studies, dissemination of guideline information in three [ 56 , 57 , 65 ] and educational sessions on diagnosis of otitis media in one [ 58 ].…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-nine studies (62%) [ 20 – 23 , 25 – 27 , 29 , 34 , 36 – 39 , 41 , 44 , 45 , 47 – 50 , 52 , 53 , 55 , 60 – 65 ] reported positive results for all outcomes measured; fourteen studies (30%) [ 24 , 31 , 32 , 35 , 40 , 42 , 43 , 46 , 51 , 54 , 57 – 59 , 66 ] reported positive results for some outcomes, and results that were not statistically influenced by the intervention for others; only four studies [ 28 , 30 , 33 , 56 ] failed to report significant post-intervention improvements for all outcomes.…”

Section: Resultsmentioning

confidence: 99%

“…While some studies conducted no post-intervention follow-up of participants [ 20 , 21 , 23 , 25 , 26 , 29 , 30 , 32 , 34 , 36 , 38 , 39 , 41 , 43 , 44 , 46 , 47 , 54 , 57 – 66 ], others followed up their participants for different periods, ranging from two months [ 22 ] to three [ 27 , 37 , 40 , 42 , 48 – 50 , 56 ], six [ 31 , 33 , 35 , 45 , 53 ], twelve [ 24 , 55 ] and twenty-four months [ 28 , 52 ].…”

Section: Resultsmentioning

confidence: 99%

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Educational interventions to improve prescription and dispensing of antibiotics: a systematic review

et al. 2014

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BackgroundExcessive and inappropriate antibiotic use contributes to growing antibiotic resistance, an important public-health problem. Strategies must be developed to improve antibiotic-prescribing. Our purpose is to review of educational programs aimed at improving antibiotic-prescribing by physicians and/or antibiotic-dispensing by pharmacists, in both primary-care and hospital settings.MethodsWe conducted a critical systematic search and review of the relevant literature on educational programs aimed at improving antibiotic prescribing and dispensing practice in primary-care and hospital settings, published in January 2001 through December 2011.ResultsWe identified 78 studies for analysis, 47 in primary-care and 31 in hospital settings. The studies differed widely in design but mostly reported positive results. Outcomes measured in the reviewed studies were adherence to guidelines, total of antibiotics prescribed, or both, attitudes and behavior related to antibiotic prescribing and quality of pharmacy practice related to antibiotics. Twenty-nine studies (62%) in primary care and twenty-four (78%) in hospital setting reported positive results for all measured outcomes; fourteen studies (30%) in primary care and six (20%) in hospital setting reported positive results for some outcomes and results that were not statistically influenced by the intervention for others; only four studies in primary care and one study in hospital setting failed to report significant post-intervention improvements for all outcomes. Improvement in adherence to guidelines and decrease of total of antibiotics prescribed, after educational interventions, were observed, respectively, in 46% and 41% of all the reviewed studies. Changes in behaviour related to antibiotic-prescribing and improvement in quality of pharmacy practice was observed, respectively, in four studies and one study respectively.ConclusionThe results show that antibiotic use could be improved by educational interventions, being mostly used multifaceted interventions.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-1276) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Educational interventions to improve prescription and dispensing of antibiotics: a systematic review

et al. 2014

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“…Prescribing has been described as done in a habitual manner [3,23–25], based on the trust of broad-spectrum antibiotics as being more effective [26], and being influenced by the structure of the healthcare system [25]. In primary care the patient–physician relationship seems to influence how antibiotics are prescribed [27,28].…”

Section: Discussionmentioning

confidence: 99%

Awareness of antibiotic resistance and antibiotic prescribing in UTI treatment: A qualitative study among primary care physicians in Sweden

Björkman

Berg

Viberg

et al. 2013

Scandinavian Journal of Primary Health Care

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Objectives. To improve education and information for general practitioners in relation to rational antibiotic prescribing for urinary tract infection (UTI), it is important to be aware of GPs’ views of resistance and how it influences their choice of UTI treatment. The aim of this study was to explore variations in views of resistance and UTI treatment decisions among general practitioners (GPs) in a county in Sweden. Design. Qualitative, semi-structured interviews were analysed with a phenomenographic approach and content analysis. Setting. Primary care in Kronoberg, a county in southern Sweden. Subjects. A purposeful sample of 20 GPs from 15 of 25 health centres in the county. Main outcome measures. The variation of perceptions of antibiotic resistance in UTI treatment. How UTIs were treated according to the GPs. Results. Three different ways of viewing resistance in UTI treatment were identified. These were: (A) No problem, I have never seen resistance, (B) The problem is bigger somewhere else, and (C) The development of antibiotic resistance is serious and we must be careful. Moreover, GPs’ perceptions of antibiotic resistance were mirrored in how they reported their treatment of UTIs in practice. Conclusion. There was a hierarchal scale of how GPs viewed resistance as an issue in UTI treatment. Only GPs who expressed concerns about resistance followed prescribing guidelines completely. This offers valuable insights into the planning and most likely the outcome of awareness or educational activities aimed at changed antibiotic prescribing behaviour.

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“…There are several different studies assessing the efficacy of measures that can be taken to reduce prescribing of antibiotics for UAI. Education of both parents and health professionals, educational videos playing in emergency service waiting rooms and information leaflets can all be effective (1,(25)(26)(27) .…”

Section: Discussionmentioning

confidence: 99%

Perfil de prescritores e prescrição de antimicrobianos nas infecções das vias aéreas superiores em Pediatria

Rocha

Fiol

Junqueira

et al. 2012

Rev. paul. pediatr.

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OBJETIVO: Traçar um perfil dos médicos que atendem crianças nos sistemas público (Sistema Único de Saúde) e privado de saúde e verificar como são prescritos antimicrobianos nas infecções das vias aéreas superiores. MÉTODOS: Médicos de algumas cidades do interior do Estado de São Paulo receberam via correio ou nas Unidades Básicas de Saúde uma carta explicativa sobre a pesquisa e o questionário, com perguntas sobre: tempo de graduação, residência médica, carga horária e local de trabalho, forma de atualização, fatores que consideram ao prescrever antimicrobianos e casos clínicos sobre as infecções das vias aéreas superiores. Os dados pessoais dos médicos foram relacionados com as respostas aos casos clínicos. Para análise estatística, foram aplicados os testes Z e de Tukey-Kramer, sendo p<0,05 significante. RESULTADOS: A amostra foi composta por 170 prescritores: 86,5% possuíam residência em Pediatria, 75% trabalhavam no Sistema Único de Saúde e 71% tinham carga horária superior a 40 horas semanais. Os formados há menos de dez anos valorizaram mais os laboratórios farmacêuticos como forma de atualização do que os graduados há mais de 30 anos; 33% dos médicos do Sistema Único de Saúde atendem mais de cinco pacientes por hora. A média de acerto nos casos clínicos foi de 87%. O uso das entidades médicas como forma de atualização foi associado a respostas corretas, enquanto o uso de materiais de laboratório estava ligado a respostas incorretas (p<0,05). Houve clara tendência de diminuição dos acertos conforme o número de pacientes atendidos por hora aumentava. CONCLUSÕES: Educação adequada sobre o tema e melhora nas condições de trabalho podem ser eficientes para reduzir a prescrição de antibióticos para infecções das vias aéreas superiores em crianças.

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Effect of educational outreach on general practice prescribing of antibiotics and antidepressants: A two-year randomised controlled trial

Cited by 19 publications

References 14 publications

Educational interventions to improve prescription and dispensing of antibiotics: a systematic review

Educational interventions to improve prescription and dispensing of antibiotics: a systematic review

Awareness of antibiotic resistance and antibiotic prescribing in UTI treatment: A qualitative study among primary care physicians in Sweden

Perfil de prescritores e prescrição de antimicrobianos nas infecções das vias aéreas superiores em Pediatria

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