Document Detail


Effectiveness of physician-targeted interventions to improve antibiotic use for respiratory tract infections.
MedLine Citation:
PMID:  23211259     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Antibiotic use and concomitant resistance are increasing. Literature reviews do not unambiguously indicate which interventions are most effective in improving antibiotic prescribing practice.
AIM: To assess the effectiveness of physician-targeted interventions aiming to improve antibiotic prescribing for respiratory tract infections (RTIs) in primary care, and to identify intervention features mostly contributing to intervention success.
DESIGN AND SETTING: Analysis of a set of physician-targeted interventions in primary care.
METHOD: A literature search (1990-2009) for studies describing the effectiveness of interventions aiming to optimise antibiotic prescription for RTIs by primary care physicians. Intervention features were extracted and effectiveness sizes were calculated. Association between intervention features and intervention success was analysed in multivariate regression analysis.
RESULTS: This study included 58 studies, describing 87 interventions of which 60% significantly improved antibiotic prescribing; interventions aiming to decrease overall antibiotic prescription were more frequently effective than interventions aiming to increase first choice prescription. On average, antibiotic prescription was reduced by 11.6%, and first choice prescription increased by 9.6%. Multiple interventions containing at least 'educational material for the physician' were most often effective. No significant added value was found for interventions containing patient-directed elements. Communication skills training and near-patient testing sorted the largest intervention effects.
CONCLUSION: This review emphasises the importance of physician education in optimising antibiotic use. Further research should focus on how to provide physicians with the relevant knowledge and tools, and when to supplement education with additional intervention elements. Feasibility should be included in this process.
Authors:
Alike W van der Velden; Eefje J Pijpers; Marijke M Kuyvenhoven; Sarah Kg Tonkin-Crine; Paul Little; Theo Jm Verheij
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of general practice : the journal of the Royal College of General Practitioners     Volume:  62     ISSN:  1478-5242     ISO Abbreviation:  Br J Gen Pract     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9005323     Medline TA:  Br J Gen Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  801-7     Citation Subset:  IM    
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
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