Effectiveness of general practitioner online training and an information booklet for parents on antibiotic prescribing for children with respiratory tract infection in primary care: a cluster randomized controlled trial
| Autor: | Paul Little, Berna D L Broekhuizen, Anne R J Dekker, Alike W van der Velden, Theo J M Verheij, Elisabeth A. M. Sanders, Christopher C Butler, Nick A Francis, Nicolaas P.A. Zuithoff, Jochen W L Cals, Lucy Yardley |
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| Přispěvatelé: | RS: CAPHRI - R5 - Optimising Patient Care, Family Medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Microbiology (medical)
Adult Male Parents medicine.medical_specialty Randomization 020205 medical informatics Adolescent MEDLINE 02 engineering and technology Disease Rate ratio Disease cluster law.invention Education Distance 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law General Practitioners Intervention (counseling) 0202 electrical engineering electronic engineering information engineering medicine MANAGEMENT Humans Pharmacology (medical) 030212 general & internal medicine Child Health Education Respiratory Tract Infections EXPECTATIONS Pharmacology Respiratory tract infections Primary Health Care business.industry Infant Newborn Infant Middle Aged Drug Utilization Anti-Bacterial Agents Infectious Diseases Family medicine Child Preschool Education Medical Continuing Female Pamphlets business |
| Zdroj: | Journal of Antimicrobial Chemotherapy, 73(5), 1416. Oxford University Press Journal of Antimicrobial Chemotherapy, 73(5), 1416-1422. Oxford University Press |
| ISSN: | 0305-7453 |
| DOI: | 10.1093/jac/dkx542 |
| Popis: | © The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. Objectives: Antibiotics are too often prescribed in childhood respiratory tract infection (RTI), despite limited effectiveness, potential side effects and bacterial resistance. We aimed to reduce antibiotic prescribing for children with RTI by online training for general practitioners (GPs) and information for parents. Methods: A pragmatic cluster randomized controlled trial in primary care. The intervention consisted of online training for GPs and an information booklet for parents. The primary outcome was the antibiotic prescription rate for children presenting with RTI symptoms, as registered by GPs. Secondary outcomes were number of reconsultations within the same disease episode, consultations for new episodes, hospital referrals and pharmacydispensed antibiotic courses for children. This trial was registered at the Dutch Trial Register (NTR), registration number: NTR4240. Results: After randomization, GPs from a total of 32 general practices registered 1009 consultations. An antibiotic was prescribed in 21% of consultations in the intervention group, compared with 33% in the usual care group, controlled for baseline prescribing (rate ratio 0.65, 95% CI 0.46-0.91). The probability of reconsulting during the same RTI episode did not differ significantly between the intervention and control groups, and nor did the numbers of consultations for new episodes and hospital referrals. In the intervention group antibiotic dispensing was 32 courses per 1000 children/year lower than the control group, adjusted for baseline prescribing (rate ratio 0.78, 95% CI 0.66-0.92). The numbers and proportion of second-choice antibiotics did not differ significantly. Conclusions: Concise, feasible, online GP training, with an information booklet for parents, showed a relevant reduction in antibiotic prescribing for children with RTI. |
| Databáze: | OpenAIRE |
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