Results from a Patient-Based Health Education Intervention in Reducing Antibiotic Use for Acute Upper Respiratory Tract Infections in the Private Sector Primary Care Setting in Singapore

Autor: Tat Yean Tham, Adrian Zhongxian Poh, Wei Mon Wong, Yee Sin Leo, Fong Seng Lim, Lili Jiang, Joyce Huixin Huang, Tau Hong Lee, Yue Yu, Magdalene Hui Min Lee, Joash Wen Chen Chong, Ee Hui Goh, Darius Shaw Teng Pan, Chia Siong Wong, Mark I-Cheng Chen, Victor Weng Keong Loh
Přispěvatelé: Lee Kong Chian School of Medicine (LKCMedicine)
Rok vydání: 2016
Předmět:
medicine.medical_specialty
Psychological intervention
Intervention
Inappropriate Prescribing
030204 cardiovascular system & hematology
antibiotics
law.invention
Epidemiology and Surveillance
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
medicine
Antimicrobial stewardship
Humans
Pharmacology (medical)
030212 general & internal medicine
Medical prescription
Practice Patterns
Physicians'
Health Education
Respiratory Tract Infections
intervention
Pharmacology
Singapore
Respiratory tract infections
Primary Health Care
business.industry
Odds ratio
medicine.disease
Upper Respiratory Tract Infection
Anti-Bacterial Agents
antimicrobial stewardship
Infectious Diseases
Upper respiratory tract infection
upper respiratory tract infection
Influenza Vaccines
Emergency medicine
Health education
Pamphlets
business
Zdroj: Antimicrobial Agents and Chemotherapy
ISSN: 1098-6596
Popis: We investigated the efficacy of patient-targeted education in reducing antibiotic prescriptions for upper respiratory tract infections (URTIs) among adults in the private primary care setting in Singapore. Our randomized controlled trial enrolled patients aged 21 years and above presenting at general practitioner (GP) clinics with URTI symptoms for 7 days or less. Intervention arm patients were verbally educated via pamphlets about the etiology of URTIs, the role of antibiotics in treating URTIs, and the consequences of inappropriate antibiotic use. Control arm patients were educated on influenza vaccinations. Both arms were compared regarding the proportions prescribed antibiotics and the patients' postconsultation views. A total of 914 patients consulting 35 doctors from 24 clinics completed the study (457 in each arm). The demographics of patients in both arms were similar, and 19.1% were prescribed an antibiotic, but this varied from 0% to 70% for individual GPs. The intervention did not significantly reduce antibiotic prescriptions (odds ratio [OR], 1.20; 95% confidence interval [CI], 0.83–1.73) except in patients of Indian ethnicity (OR, 0.28; 95% CI, 0.09–0.93). Positive associations between the intervention and the view that antibiotics were not needed most of the time for URTIs ( P = 0.047) and on being worried about the side effects of antibiotics ( P = 0.018) were restricted to the Indian subgroup. GPs in limited liability partnerships or clinic chains prescribed less (OR, 0.36; 95% CI, 0.14 to 0.92), while certain inappropriate patient responses were associated with the receipt of antibiotics. Follow-up studies to investigate differences in responses to educational programs between ethnicities and to explore GP-targeted interventions are recommended.
Databáze: OpenAIRE
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