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- Title
Long-term effect of a practice-based intervention (HAPPY AUDIT) aimed at reducing antibiotic prescribing in patients with respiratory tract infections.
- Authors
Llor, Carl; Bjerrum, Lars; Molero, José M; Moragas, Ana; González López-Valcárcel, Beatriz; Monedero, M José; Gómez, Manuel; Cid, Marina; Alcántara, Juan de Dios; Cots, Josep M; Ribas, Joana M; García, Guillermo; Ortega, Jesús; Pineda, Vicenta; Guerra, Gloria; Munuera, Susana; HAPPY AUDIT 3 Study Team
- Abstract
<bold>Objectives: </bold>Few studies have evaluated the long-term effects of educational interventions on antibiotic prescription and the results are controversial. This study was aimed at assessing the effect of a multifaceted practice-based intervention carried out 6 years earlier on current antibiotic prescription for respiratory tract infections (RTIs).<bold>Methods: </bold>The 210 general practitioners (GPs) who completed the first two registrations in 2008 and 2009 were invited to participate in a third registration. The intervention held before the second registration consisted of discussion about the first registration of results, appropriate use of antibiotics for RTIs, patient brochures, a workshop and the provision of rapid tests. As in the previous registrations, GPs were instructed to complete a template for all the patients with RTIs during 15 working days in 2015. A new group of GPs from the same areas was also invited to participate and acted as controls. A multilevel logistic regression analysis was performed considering the prescription of antibiotics as the dependent variable.<bold>Results: </bold>A total of 121 GPs included in the 2009 intervention (57.6%) and 117 control GPs registered 22 247 RTIs. On adjustment for covariables, compared with the antibiotic prescription observed just after the intervention, GPs assigned to intervention prescribed slightly more antibiotics 6 years later albeit without statistically significant differences (OR 1.08, 95% CI 0.89-1.31, P = 0.46), while GPs in the control group prescribed significantly more antibiotics (OR 2.74, 95% CI 2.09-3.59, P < 0.001).<bold>Conclusions: </bold>This study shows that a single multifaceted intervention continues to reduce antibiotic prescribing 6 years later.
- Subjects
ANTIBIOTICS; DRUG utilization statistics; BEHAVIOR therapy; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; MEDICAL education; MEDICAL prescriptions; RESEARCH; RESPIRATORY infections; TIME; EVALUATION research
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2018, Vol 73, Issue 8, p2215
- ISSN
0305-7453
- Publication type
journal article
- DOI
10.1093/jac/dky137