Reducing inappropriate outpatient antibiotic prescribing: normative comparison using unblinded provider reports
| Autor: | Jonathan Entwisle, Jefferson G Bohan, Richard V. Milani, Jonathan K. Wilt, Pedro Cazabon, Jonathan Hand |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Leadership and Management medicine.drug_class Antibiotics Inappropriate Prescribing decision making Antibiotic resistance Physicians Intervention (counseling) Outpatients Global health Humans Medicine Practice Patterns Physicians' Respiratory Tract Infections Primary Health Care Respiratory tract infections business.industry Health Policy Public Health Environmental and Occupational Health Evidence-based medicine Middle Aged Anti-Bacterial Agents Emergency medicine Normative Original Article Female antibiotic management evidence-based medicine business Patient education |
| Zdroj: | BMJ Open Quality |
| ISSN: | 2399-6641 |
| DOI: | 10.1136/bmjoq-2018-000351 |
| Popis: | ImportanceAntibiotic resistance is a global health issue. Up to 50% of antibiotics are inappropriately prescribed, the majority of which are for acute respiratory tract infections (ARTI).ObjectiveTo evaluate the impact of unblinded normative comparison on rates of inappropriate antibiotic prescribing for ARTI.DesignNon-randomised, controlled interventional trial over 1 year followed by an open intervention in the second year.SettingPrimary care providers in a large regional healthcare system.ParticipantsThe test group consisted of 30 primary care providers in one geographical region; controls consisted of 162 primary care providers located in four other geographical regions.InterventionThe intervention consisted of provider and patient education and provider feedback via biweekly, unblinded normative comparison highlighting inappropriate antibiotic prescribing for ARTI. The intervention was applied to both groups during the second year.Main outcomes and measuresRate of inappropriate antibiotic prescription for ARTI.ResultsBaseline inappropriate antibiotic prescribing for ARTI was 60%. After 1 year, the test group rate of inappropriate antibiotic prescribing decreased 40%, from 51.9% to 31.0% (pConclusions and relevanceProvider and patient education followed by regular feedback to provider via normative comparison to their local peers through unblinded provider reports, lead to reductions in the rate of inappropriate antibiotic prescribing for ARTI and overall antibiotic prescribing rates. |
| Databáze: | OpenAIRE |
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