Long-term effect of a practice-based intervention (HAPPY AUDIT) aimed at reducing antibiotic prescribing in patients with respiratory tract infections

HAPPY AUDIT 3 Study Team

doi:10.1093/jac/dky137

Long-term effect of a practice-based intervention (HAPPY AUDIT) aimed at reducing antibiotic prescribing in patients with respiratory tract infections

HAPPY AUDIT 3 Study Team

Afdeling for Almen Medicin

8 Citationer (Scopus)

Abstract

Objectives: 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). Methods: 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. Results: A total of 121 GPs included in the 2009 intervention (57.6%) and 117 control GPs registered 22247 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). Conclusions: This study shows that a single multifaceted intervention continues to reduce antibiotic prescribing 6 years later.

Originalsprog	Engelsk
Tidsskrift	The Journal of antimicrobial chemotherapy
Vol/bind	73
Udgave nummer	8
Sider (fra-til)	2215-2222
Antal sider	8
ISSN	0305-7453
DOI	https://doi.org/10.1093/jac/dky137
Status	Udgivet - 1 aug. 2018

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10.1093/jac/dky137

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https://academic.oup.com/jac/article-pdf/73/8/2215/25178718/dky137.pdf

Citationsformater

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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",

abstract = "Objectives: 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). Methods: 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. Results: A total of 121 GPs included in the 2009 intervention (57.6%) and 117 control GPs registered 22247 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). Conclusions: This study shows that a single multifaceted intervention continues to reduce antibiotic prescribing 6 years later.",

author = "Carl Llor and Lars Bjerrum and Molero, {Jos{\'e} M} and Ana Moragas and {Gonz{\'a}lez L{\'o}pez-Valc{\'a}rcel}, Beatriz and Monedero, {M Jos{\'e}} and Manuel G{\'o}mez and Marina Cid and Alc{\'a}ntara, {Juan de Dios} and Cots, {Josep M} and Ribas, {Joana M} and Guillermo Garc{\'i}a and Jes{\'u}s Ortega and Vicenta Pineda and Gloria Guerra and Susana Munuera and {HAPPY AUDIT 3 Study Team}",

year = "2018",

month = aug,

day = "1",

doi = "10.1093/jac/dky137",

language = "English",

volume = "73",

pages = "2215--2222",

journal = "Journal of Antimicrobial Chemotherapy",

issn = "0305-7453",

publisher = "Oxford University Press",

number = "8",

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TY - JOUR

T1 - Long-term effect of a practice-based intervention (HAPPY AUDIT) aimed at reducing antibiotic prescribing in patients with respiratory tract infections

AU - Llor, Carl

AU - Bjerrum, Lars

AU - Molero, José M

AU - Moragas, Ana

AU - González López-Valcárcel, Beatriz

AU - Monedero, M José

AU - Gómez, Manuel

AU - Cid, Marina

AU - Alcántara, Juan de Dios

AU - Cots, Josep M

AU - Ribas, Joana M

AU - García, Guillermo

AU - Ortega, Jesús

AU - Pineda, Vicenta

AU - Guerra, Gloria

AU - Munuera, Susana

AU - HAPPY AUDIT 3 Study Team

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Objectives: 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). Methods: 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. Results: A total of 121 GPs included in the 2009 intervention (57.6%) and 117 control GPs registered 22247 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). Conclusions: This study shows that a single multifaceted intervention continues to reduce antibiotic prescribing 6 years later.

AB - Objectives: 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). Methods: 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. Results: A total of 121 GPs included in the 2009 intervention (57.6%) and 117 control GPs registered 22247 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). Conclusions: This study shows that a single multifaceted intervention continues to reduce antibiotic prescribing 6 years later.

U2 - 10.1093/jac/dky137

DO - 10.1093/jac/dky137

M3 - Journal article

C2 - 29718420

SN - 0305-7453

VL - 73

SP - 2215

EP - 2222

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

IS - 8

ER -

Long-term effect of a practice-based intervention (HAPPY AUDIT) aimed at reducing antibiotic prescribing in patients with respiratory tract infections

Abstract

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