Effectiveness of two types of intervention on antibiotic prescribing in respiratory tract infections in Primary Care in Spain:  Happy Audit Study

Carles Llor; Josep Maria Cots; Silvia Hernández; Jesús Ortega; Javier Arranz; María José Monedero; Juan de Dios Alcántara; Carolina Pérez; Guillermo García; Manuel Gómez; Gloria Guerra; Marina Cid; María Luisa Cigüenza; Vicenta Pineda; José Paredes; Juan Luis Burgazzoli; Anders Munck; Gloria Cristina Cordoba Currea; Lars Bjerrum; Happy Audit Study Group

doi:10.1016/j.aprim.2014.02.006

Effectiveness of two types of intervention on antibiotic prescribing in respiratory tract infections in Primary Care in Spain: Happy Audit Study

Carles Llor, Josep Maria Cots, Silvia Hernández, Jesús Ortega, Javier Arranz, María José Monedero, Juan de Dios Alcántara, Carolina Pérez, Guillermo García, Manuel Gómez, Gloria Guerra, Marina Cid, María Luisa Cigüenza, Vicenta Pineda, José Paredes, Juan Luis Burgazzoli, Anders Munck, Gloria Cristina Cordoba Currea, Lars Bjerrum, Happy Audit Study Group

16 Citations (Scopus)

Abstract

Interventions: Intervention activities included meetings, with the presentation and discussion of the results, and several training meetings on RTI guidelines, information brochures for patients, workshops on point-of-care tests - rapid antigen detection tests and C-reactive protein rapid test - and provision of these tests in the clinic. All GPs, with the exception of those in Catalonia, made up the full intervention group (FIG); conversely, Catalan doctors underwent the same intervention, except for the workshop on rapid tests (partial intervention group, PIG). Multilevel logistic regression was performed taking the prescription of antibiotics as the dependent variable.

Objective: To evaluate the effectiveness of two types of intervention in reducing antibiotic prescribing in respiratory tract infections (RTI).

Design: Before-after audit-based study.

Setting: Primary Care centres in Spain.

Participants: General practitioners (GPs) registered all patients with RTIs for 15 days in winter 2008 (pre-intervention), and again in winter 2009 (post-intervention).

Results: Out of a total of 309 GPs involved in the first register, 281 completed the intervention and the second register (90.9%), of which 210 were assigned to the FIG, and 71 to the PIG. The odds ratio of antibiotic prescribing after the intervention was 0.99 (95% CI: 0.89-1.10) among GPs assigned to PIG, and 0.50 (95% CI: 0.44-0.57, p < 0.001) among those who were allocated to FIG. The reduction in antibiotic prescribing in FIG was more marked in flu infection, common cold, acute pharyngitis, acute tonsillitis, and acute bronchitis.

Conclusions: Active participation of GPs with the performance of point-of-care tests in the clinic is accompanied by a drastic reduction of antibiotic use in RTIs, primarily in infections considered as mainly viral.

Original language	English
Journal	Atencion Primaria
Volume	46
Issue number	9
Pages (from-to)	492-500
Number of pages	9
ISSN	0212-6567
DOIs	https://doi.org/10.1016/j.aprim.2014.02.006
Publication status	Published - 1 Nov 2014

Access to Document

10.1016/j.aprim.2014.02.006

Cite this

Llor, C., Cots, J. M., Hernández, S., Ortega, J., Arranz, J., Monedero, M. J., Alcántara, J. D. D., Pérez, C., García, G., Gómez, M., Guerra, G., Cid, M., Cigüenza, M. L., Pineda, V., Paredes, J., Burgazzoli, J. L., Munck, A., Cordoba Currea, G. C., Bjerrum, L., & Happy Audit Study Group (2014). Effectiveness of two types of intervention on antibiotic prescribing in respiratory tract infections in Primary Care in Spain: Happy Audit Study. Atencion Primaria, 46(9), 492-500. https://doi.org/10.1016/j.aprim.2014.02.006

Llor, C, Cots, JM, Hernández, S, Ortega, J, Arranz, J, Monedero, MJ, Alcántara, JDD, Pérez, C, García, G, Gómez, M, Guerra, G, Cid, M, Cigüenza, ML, Pineda, V, Paredes, J, Burgazzoli, JL, Munck, A, Cordoba Currea, GC , Bjerrum, L & Happy Audit Study Group 2014, 'Effectiveness of two types of intervention on antibiotic prescribing in respiratory tract infections in Primary Care in Spain: Happy Audit Study', Atencion Primaria, vol. 46, no. 9, pp. 492-500. https://doi.org/10.1016/j.aprim.2014.02.006

@article{82584a12b7144dd1904c59d85ddfe782,

title = "Effectiveness of two types of intervention on antibiotic prescribing in respiratory tract infections in Primary Care in Spain: Happy Audit Study",

abstract = "Interventions: Intervention activities included meetings, with the presentation and discussion of the results, and several training meetings on RTI guidelines, information brochures for patients, workshops on point-of-care tests - rapid antigen detection tests and C-reactive protein rapid test - and provision of these tests in the clinic. All GPs, with the exception of those in Catalonia, made up the full intervention group (FIG); conversely, Catalan doctors underwent the same intervention, except for the workshop on rapid tests (partial intervention group, PIG). Multilevel logistic regression was performed taking the prescription of antibiotics as the dependent variable.Objective: To evaluate the effectiveness of two types of intervention in reducing antibiotic prescribing in respiratory tract infections (RTI).Design: Before-after audit-based study.Setting: Primary Care centres in Spain.Participants: General practitioners (GPs) registered all patients with RTIs for 15 days in winter 2008 (pre-intervention), and again in winter 2009 (post-intervention).Results: Out of a total of 309 GPs involved in the first register, 281 completed the intervention and the second register (90.9%), of which 210 were assigned to the FIG, and 71 to the PIG. The odds ratio of antibiotic prescribing after the intervention was 0.99 (95% CI: 0.89-1.10) among GPs assigned to PIG, and 0.50 (95% CI: 0.44-0.57, p < 0.001) among those who were allocated to FIG. The reduction in antibiotic prescribing in FIG was more marked in flu infection, common cold, acute pharyngitis, acute tonsillitis, and acute bronchitis.Conclusions: Active participation of GPs with the performance of point-of-care tests in the clinic is accompanied by a drastic reduction of antibiotic use in RTIs, primarily in infections considered as mainly viral.",

author = "Carles Llor and Cots, {Josep Maria} and Silvia Hern{\'a}ndez and Jes{\'u}s Ortega and Javier Arranz and Monedero, {Mar{\'i}a Jos{\'e}} and Alc{\'a}ntara, {Juan de Dios} and Carolina P{\'e}rez and Guillermo Garc{\'i}a and Manuel G{\'o}mez and Gloria Guerra and Marina Cid and Cig{\"u}enza, {Mar{\'i}a Luisa} and Vicenta Pineda and Jos{\'e} Paredes and Burgazzoli, {Juan Luis} and Anders Munck and {Cordoba Currea}, {Gloria Cristina} and Lars Bjerrum and {Happy Audit Study Group}",

year = "2014",

month = nov,

day = "1",

doi = "10.1016/j.aprim.2014.02.006",

language = "English",

volume = "46",

pages = "492--500",

journal = "Atencion Primaria",

issn = "0212-6567",

publisher = "Elsevier Doyma",

number = "9",

}

TY - JOUR

T1 - Effectiveness of two types of intervention on antibiotic prescribing in respiratory tract infections in Primary Care in Spain

T2 - Happy Audit Study

AU - Llor, Carles

AU - Cots, Josep Maria

AU - Hernández, Silvia

AU - Ortega, Jesús

AU - Arranz, Javier

AU - Monedero, María José

AU - Alcántara, Juan de Dios

AU - Pérez, Carolina

AU - García, Guillermo

AU - Gómez, Manuel

AU - Guerra, Gloria

AU - Cid, Marina

AU - Cigüenza, María Luisa

AU - Pineda, Vicenta

AU - Paredes, José

AU - Burgazzoli, Juan Luis

AU - Munck, Anders

AU - Cordoba Currea, Gloria Cristina

AU - Bjerrum, Lars

AU - Happy Audit Study Group

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Interventions: Intervention activities included meetings, with the presentation and discussion of the results, and several training meetings on RTI guidelines, information brochures for patients, workshops on point-of-care tests - rapid antigen detection tests and C-reactive protein rapid test - and provision of these tests in the clinic. All GPs, with the exception of those in Catalonia, made up the full intervention group (FIG); conversely, Catalan doctors underwent the same intervention, except for the workshop on rapid tests (partial intervention group, PIG). Multilevel logistic regression was performed taking the prescription of antibiotics as the dependent variable.Objective: To evaluate the effectiveness of two types of intervention in reducing antibiotic prescribing in respiratory tract infections (RTI).Design: Before-after audit-based study.Setting: Primary Care centres in Spain.Participants: General practitioners (GPs) registered all patients with RTIs for 15 days in winter 2008 (pre-intervention), and again in winter 2009 (post-intervention).Results: Out of a total of 309 GPs involved in the first register, 281 completed the intervention and the second register (90.9%), of which 210 were assigned to the FIG, and 71 to the PIG. The odds ratio of antibiotic prescribing after the intervention was 0.99 (95% CI: 0.89-1.10) among GPs assigned to PIG, and 0.50 (95% CI: 0.44-0.57, p < 0.001) among those who were allocated to FIG. The reduction in antibiotic prescribing in FIG was more marked in flu infection, common cold, acute pharyngitis, acute tonsillitis, and acute bronchitis.Conclusions: Active participation of GPs with the performance of point-of-care tests in the clinic is accompanied by a drastic reduction of antibiotic use in RTIs, primarily in infections considered as mainly viral.

AB - Interventions: Intervention activities included meetings, with the presentation and discussion of the results, and several training meetings on RTI guidelines, information brochures for patients, workshops on point-of-care tests - rapid antigen detection tests and C-reactive protein rapid test - and provision of these tests in the clinic. All GPs, with the exception of those in Catalonia, made up the full intervention group (FIG); conversely, Catalan doctors underwent the same intervention, except for the workshop on rapid tests (partial intervention group, PIG). Multilevel logistic regression was performed taking the prescription of antibiotics as the dependent variable.Objective: To evaluate the effectiveness of two types of intervention in reducing antibiotic prescribing in respiratory tract infections (RTI).Design: Before-after audit-based study.Setting: Primary Care centres in Spain.Participants: General practitioners (GPs) registered all patients with RTIs for 15 days in winter 2008 (pre-intervention), and again in winter 2009 (post-intervention).Results: Out of a total of 309 GPs involved in the first register, 281 completed the intervention and the second register (90.9%), of which 210 were assigned to the FIG, and 71 to the PIG. The odds ratio of antibiotic prescribing after the intervention was 0.99 (95% CI: 0.89-1.10) among GPs assigned to PIG, and 0.50 (95% CI: 0.44-0.57, p < 0.001) among those who were allocated to FIG. The reduction in antibiotic prescribing in FIG was more marked in flu infection, common cold, acute pharyngitis, acute tonsillitis, and acute bronchitis.Conclusions: Active participation of GPs with the performance of point-of-care tests in the clinic is accompanied by a drastic reduction of antibiotic use in RTIs, primarily in infections considered as mainly viral.

U2 - 10.1016/j.aprim.2014.02.006

DO - 10.1016/j.aprim.2014.02.006

M3 - Journal article

C2 - 24768657

SN - 0212-6567

VL - 46

SP - 492

EP - 500

JO - Atencion Primaria

JF - Atencion Primaria

IS - 9

ER -

Effectiveness of two types of intervention on antibiotic prescribing in respiratory tract infections in Primary Care in Spain: Happy Audit Study

Abstract

Access to Document

Fingerprint

Cite this