Effect of Public Disclosure on Antibiotic Prescription Rate for Upper Respiratory Tract Infections

Yun, Jae Moon; Shin, Dong Wook; Hwang, Seung-Sik; Cho, Juhee; Nam, You Seon; Kim, Jung Hoe; Cho, Belong

doi:10.1001/jamainternmed.2014.6569

Cited by 13 publications

(6 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinical indicators regarding performance improvement and regular result reporting may be an excellent way to promote the use of the MDSS and gain trust. For example, public disclosure of antibiotic use rates effectively lowered the use of antibiotics for upper respiratory infections in South Korea [ 40 ]. Likewise, public disclosure about ADEs prevented by using the MDSS may help reduce alert override rates.…”

Section: Discussionmentioning

confidence: 99%

Barriers and Facilitators to Implementation of Medication Decision Support Systems in Electronic Medical Records: Mixed Methods Approach Based on Structural Equation Modeling and Qualitative Analysis

Jung

Lee

et al. 2020

JMIR Med Inform

View full text Add to dashboard Cite

Background Adverse drug events (ADEs) resulting from medication error are some of the most common causes of iatrogenic injuries in hospitals. With the appropriate use of medication, ADEs can be prevented and ameliorated. Efforts to reduce medication errors and prevent ADEs have been made by implementing a medication decision support system (MDSS) in electronic health records (EHRs). However, physicians tend to override most MDSS alerts. Objective In order to improve MDSS functionality, we must understand what factors users consider essential for the successful implementation of an MDSS into their clinical setting. This study followed the implementation process for an MDSS within a comprehensive EHR system and analyzed the relevant barriers and facilitators. Methods A mixed research methodology was adopted. Data from a structured survey and 15 in-depth interviews were integrated. Structural equation modeling was conducted for quantitative analysis of factors related to user adoption of MDSS. Qualitative analysis based on semistructured interviews with physicians was conducted to collect various opinions on MDSS implementation. Results Quantitative analysis revealed that physicians’ expectations regarding ease of use and performance improvement are crucial. Qualitative analysis identified four significant barriers to MDSS implementation: alert fatigue, lack of accuracy, poor user interface design, and lack of customizability. Conclusions This study revealed barriers and facilitators to the implementation of MDSS. The findings can be applied to upgrade MDSS in the future.

show abstract

Section: Discussionmentioning

confidence: 99%

Barriers and Facilitators to Implementation of Medication Decision Support Systems in Electronic Medical Records: Mixed Methods Approach Based on Structural Equation Modeling and Qualitative Analysis

Jung

Lee

et al. 2020

JMIR Med Inform

View full text Add to dashboard Cite

show abstract

“…Thus, various and relatively effective health policies have been implemented to promote the prudent use of antibiotics, particularly for acute RTIs. These policies include separation of prescribing from dispensing, public educational campaigns, and public disclosure of physicians' antibiotic prescriptions (111213). Despite a significant decrease in the past decade, the antibiotic prescription rate in Korea remains higher than the rates in other developed countries (14).…”

Section: Introductionmentioning

confidence: 99%

From Visiting a Physician to Expecting Antibiotics: Korean Perspectives and Practices toward Respiratory Tract Infections

et al. 2017

View full text Add to dashboard Cite

Antibiotic resistance is steadily rising worldwide. Respiratory tract infections (RTIs) are common indications, mostly imprudent, for antibiotic prescriptions in outpatient setting. In Korea, antibiotic prescription rate for RTIs is still high. As physician visit and antibiotic prescribing are influenced by patient's perceptions and beliefs, we aimed to explore the general public's perspectives and practices toward RTIs and to develop the ‘RTI clinical iceberg.’ A cross-sectional survey was conducted in Wonju Severance Christian Hospital (WSCH) among 550 adults attending outpatient departments during January 2016. Differences in distributions between groups were examined using two-tailed Pearson χ2 test. Using the Andersen's behavioral model as a conceptual framework, we constructed logistic regression models to assess factors associated with physician visit. Of 547 participants with complete questionnaires, 62.9% reported having experienced an RTI in the previous six months; 59.3% visited a physician for the illness, most commonly because the symptoms were severe or prolonged, and approximately 16% of them expected an antibiotic prescription from the visit. Perceptions of symptoms severity, the need factor, most strongly influenced physician visit. Predisposing and enabling factors such as inappropriate expectations for antibiotic for a sore throat or having national health insurance also influenced physician visit. Almost all participants who reported asking for an antibiotic were prescribed one, with a 37.1% non-adherence rate. Conclusively, public education on self-care for RTI symptoms that addresses their main concerns may reduce physician visits. Improving physician-patient relationship and informing patients about the lack of antibiotic benefit for most RTIs may also reduce antibiotic prescriptions.

show abstract

“…Core elements of these policies were legislative separation of drug prescribing and dispensing, drug utilization reviews, healthcare quality assessment, and public reporting. There have been few reports on the outcomes of these goverment-driven policies so far [ 17 18 ]. In this review, we describe the administrative antibiotic stewardship policies of the South Korean government and its effects on antibiotic use and resistance.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Control Policies in South Korea, 2000-2013

Kim

2016

Infect Chemother

View full text Add to dashboard Cite

Antibiotic stewardship is a key strategy for limiting antibiotic resistance. Over the last decade the South Korean government has implemented a series of healthcare policies directed to this end, consisting of legislative separation of drug prescribing and dispensing, antibiotic utilization reviews, healthcare quality assessment, and public reporting. As a result, the proportion of antibiotic prescriptions for acute upper respiratory tract infections in primary healthcare facilities decreased from 72.9% in 2002 to 42.7% in 2013. However, no significant decrease in antibiotic resistance occurred over the same period in clinically important bacteria such as Streptococcus pneumoniae. These government-driven policies played a pivotal role in improving antibiotic use for outpatients and surgical patients in South Korea. However, to achieve long-lasting successful outcomes, coordinated efforts and communications among the stakeholders, including physicians and medical societies, are needed.

show abstract

Effect of Public Disclosure on Antibiotic Prescription Rate for Upper Respiratory Tract Infections

Cited by 13 publications

References 4 publications

Barriers and Facilitators to Implementation of Medication Decision Support Systems in Electronic Medical Records: Mixed Methods Approach Based on Structural Equation Modeling and Qualitative Analysis

Barriers and Facilitators to Implementation of Medication Decision Support Systems in Electronic Medical Records: Mixed Methods Approach Based on Structural Equation Modeling and Qualitative Analysis

From Visiting a Physician to Expecting Antibiotics: Korean Perspectives and Practices toward Respiratory Tract Infections

Antibiotic Control Policies in South Korea, 2000-2013

Contact Info

Product

Resources

About