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 - The Journal of antimicrobial chemotherapy
JF - The Journal of antimicrobial chemotherapy
IS - 8
ER -