Improving physician prescribing patterns to treat rhinopharyngitis. Intervention strategies in two health systems of Mexico

Pérez‐Cuevas, Ricardo; Guiscafré, H; Muñoz, Onofre; Reyes, Hortensia; Tomé, Patricia; Libreros, Vita; Gutiérrez, Gonzalo

doi:10.1016/0277-9536(95)00398-3

Cited by 48 publications

(25 citation statements)

References 15 publications

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“…Some of the successful interventions presented in this review may seem remarkable for their simplicity, such as patient flow analysis (Hermida et al, 1996;Fenney-Lynam et al, 1994;Ammari et al, 1991;Santillan and Figueroa, 2000;Parent and Coppieters, 2001) while others are quite innovative, for instance interactive group discussions involving patients and prescribers, which resulted in reduced use of unnecessary injections (Perez-Cuevas et al, 1996). Part of the achievements are due not to the technique itself but to the process through which the changes were made possible, by applying participative approaches, gaining staff commitment and involving the community.…”

Section: Discussionmentioning

confidence: 96%

“…22 Bitran, 1995;Kanji et al, 1995;Mills A et al, 1997;Mudyarabikwa and Madhina, 2000;Gilson, 1995. 23 Chalker, 1995Haddad and Fournier, 1995;Fryatt et al, 1994;Litvack and Bodart, 1993. 24 Laing et al, 2001;Ofordi-Adjei and Arhinful, 1996;Chalker, 2001;Angunawela et al, 1991;Santoso, 1996;Hadiyono et al, 1996;Perez-Cuevas et al, 1996;Bexell et al, 1996;Birrel and Birrel, 2000;Foster, 1991. There were also reports of improved health service efficiency (improved use of physicians' time) and improved staff attitudes towards work. In relation to the interventions implementing more comprehensive changes, there were improvements in service quality (reduced perinatal and maternal mortality rates).…”

Section: Service Organization and Delivery Service Organizationmentioning

confidence: 91%

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Approaches to overcoming constraints to effective health service delivery: a review of the evidence

Oliveira-Cruz

Hanson

Mills

2003

J of Intl Development

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This paper reviews the current evidence base regarding efforts to overcome constraints to effective health service delivery in low and middle-income countries. A systematic literature review was chosen as the approach to gather and analyse existing knowledge about how to improve the 'close-to-client' health system. We focused on three levels of constraints: community and household, the health services delivery level itself, and health sector policy and strategic management. In total, 116 studies were reviewed and their main findings presented. The results should be interpreted with caution due to the considerable limitations in the existing evidence base. Copyright © 2003 John Wiley & Sons, Ltd.

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Section: Discussionmentioning

confidence: 96%

Section: Service Organization and Delivery Service Organizationmentioning

confidence: 91%

Approaches to overcoming constraints to effective health service delivery: a review of the evidence

Oliveira-Cruz

Hanson

Mills

2003

J of Intl Development

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“…4,7,22,23 An implication of our findings is the need for educational interventions that target the treatment of URTIs, especially with regard to indications for antibiotic treatment and antibiotic drug choices. Profession and university-sponsored initiatives would be preferable to pharmaceutical industry-sponsored initiatives, as industry contact was associated with inappropriate prescribing in our study and other studies.…”

Section: Discussionmentioning

confidence: 93%

“…[1][2][3][4][5][6][7] The injudicious use of antibiotics contributes to the emergence of antimicrobial resistance, decreased therapeutic effectiveness of antibiotics, and increased health care costs. 8 Decreased antibiotic use has been demonstrated to reduce antimicrobial resistance.…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting Antibiotic Decisions for Upper Respiratory Tract Infections I:A Survey of Family Physicians

Zoutman

Ford

Bassili

et al. 2008

Int. j. infect. control

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Identifying factors associated with the ubiquitous inappropriate prescribing of antibiotics for upper respiratory tract infections (URTIs) will help develop effective interventions and decrease antimicrobial resistance. Surveys were mailed to family physicians in Ontario, Canada. The survey assessed antibiotic prescribing for URTIs and a wide range of influences on antibiotic decisions. Multivariate models of inappropriate prescribing were generated. 316 of 544 (58%) family physicians completed surveys. Associated with self-reported antibiotic prescribing for acute bronchitis were patients with obligations (OR 2.1; 95% CI, 1.2-3.6), physicians with positive antibiotic use attitudes (OR 2.1; 95% CI, 1.1-3.9), satisfaction antibiotics best for patients (OR 1.5; 95% CI, 1.1-2.1), and knowledgeable patients (OR 0.5; 95% CI, 03-0.8). Associated with antibiotic prescribing for influenza were patients with obligations (OR 2.2; 95% CI, 1.2-3.8), patients thought to be seeking antibiotics (OR 1.4; 95% CI, 1.1-1.9), and attending university and profession sponsored courses (OR 0.7; 95% CI, 0.4-1.0). Associated with not prescribing first line antibiotics for acute sinusitis were pharmaceutical industry influence (OR 2.0; 95% CI, 1.1-3.3), solo practice (OR 2.0; 95% CI, 1.1-5.0), and recommending rest and simple analgesics (OR 0.5; 95% CI, 0.3-0.8). Associated with not prescribing first line antibiotics for streptococcal pharyngitis were pharmaceutical industry influence (OR 1.7; 95% CI, 1.3-2.5), physician age (OR 1.6; 95% CI, 1.3-2.1), and perceived importance of clinical guidelines (OR 0.6; 95% CI, 0.4-0.8). Health care workers should be informed of the influence of perceived patient motivation and the pharmaceutical industry on antibiotic use for URTIs and these insights included in interventions targeting inappropriate antibiotic prescribing.

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“…Additionally, four studies were excluded because they reported antibiotic prescribing by health workers other than medical doctors, such as paramedical workers, nurses, pharmacists and trained lay persons. Finally, eight studies (describing ten interventions) met all the inclusion criteria and were included in the review [40][41][42][43][44][45][46][47].…”

Section: Literature Review Outcomementioning

confidence: 99%

Interventions to Improve Antibiotic Prescribing in Upper Middle Income Countries: A Systematic Review of the Literature 1990 - 2009

Ivanovska

Holloway

2013

Maced J Med Sci

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Improving physician prescribing patterns to treat rhinopharyngitis. Intervention strategies in two health systems of Mexico

Cited by 48 publications

References 15 publications

Approaches to overcoming constraints to effective health service delivery: a review of the evidence

Approaches to overcoming constraints to effective health service delivery: a review of the evidence

Factors Affecting Antibiotic Decisions for Upper Respiratory Tract Infections I:A Survey of Family Physicians

Interventions to Improve Antibiotic Prescribing in Upper Middle Income Countries: A Systematic Review of the Literature 1990 - 2009

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