The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

Effectiveness of physician-targeted interventions to improve antibiotic use for respiratory tract infections

Effectiveness of physician-targeted interventions to improve antibiotic use for respiratory tract infections
Effectiveness of physician-targeted interventions to improve antibiotic use for respiratory tract infections
Background: antibiotic use and concomitant resistance are increasing. Literature reviews do not unambiguously indicate which interventions are most effective in improving antibiotic prescribing practice.

Aim: to assess the effectiveness of physician-targeted interventions aiming to improve antibiotic prescribing for respiratory tract infections (RTIs) in primary care, and to identify intervention features mostly contributing to intervention success.

Design and setting: analysis of a set of physician-targeted interventions in primary care.

Method: a literature search (1990-2009) for studies describing the effectiveness of interventions aiming to optimise antibiotic prescription for RTIs by primary care physicians. Intervention features were extracted and effectiveness sizes were calculated. Association between intervention features and intervention success was analysed in multivariate regression analysis.

Results: this study included 58 studies, describing 87 interventions of which 60% significantly improved antibiotic prescribing; interventions aiming to decrease overall antibiotic prescription were more frequently effective than interventions aiming to increase first choice prescription. On average, antibiotic prescription was reduced by 11.6%, and first choice prescription increased by 9.6%. Multiple interventions containing at least 'educational material for the physician' were most often effective. No significant added value was found for interventions containing patient-directed elements. Communication skills training and near-patient testing sorted the largest intervention effects.

Conclusion: this review emphasises the importance of physician education in optimising antibiotic use. Further research should focus on how to provide physicians with the relevant knowledge and tools, and when to supplement education with additional intervention elements. Feasibility should be included in this process
0960-1643
e801-e807
van der Velden, A.W.
1ad78cb7-b556-42fc-a530-aa2d6d53b758
Pijpers, E.J.
6c8763f5-3f4f-4d20-8c60-83f03231faf4
Kuyvenhoven, M.M.
65679835-9bdc-48b6-92f3-cc6322cccc4f
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Verheij, T.J.M.
c7dd556b-e4c2-42cf-b0aa-d6b19c8313d1
van der Velden, A.W.
1ad78cb7-b556-42fc-a530-aa2d6d53b758
Pijpers, E.J.
6c8763f5-3f4f-4d20-8c60-83f03231faf4
Kuyvenhoven, M.M.
65679835-9bdc-48b6-92f3-cc6322cccc4f
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Verheij, T.J.M.
c7dd556b-e4c2-42cf-b0aa-d6b19c8313d1

van der Velden, A.W., Pijpers, E.J., Kuyvenhoven, M.M., Little, P. and Verheij, T.J.M. (2012) Effectiveness of physician-targeted interventions to improve antibiotic use for respiratory tract infections. British Journal of General Practice, 62 (605), e801-e807. (doi:10.3399/bjgp12X659268). (PMID:23211259)

Record type: Article

Abstract

Background: antibiotic use and concomitant resistance are increasing. Literature reviews do not unambiguously indicate which interventions are most effective in improving antibiotic prescribing practice.

Aim: to assess the effectiveness of physician-targeted interventions aiming to improve antibiotic prescribing for respiratory tract infections (RTIs) in primary care, and to identify intervention features mostly contributing to intervention success.

Design and setting: analysis of a set of physician-targeted interventions in primary care.

Method: a literature search (1990-2009) for studies describing the effectiveness of interventions aiming to optimise antibiotic prescription for RTIs by primary care physicians. Intervention features were extracted and effectiveness sizes were calculated. Association between intervention features and intervention success was analysed in multivariate regression analysis.

Results: this study included 58 studies, describing 87 interventions of which 60% significantly improved antibiotic prescribing; interventions aiming to decrease overall antibiotic prescription were more frequently effective than interventions aiming to increase first choice prescription. On average, antibiotic prescription was reduced by 11.6%, and first choice prescription increased by 9.6%. Multiple interventions containing at least 'educational material for the physician' were most often effective. No significant added value was found for interventions containing patient-directed elements. Communication skills training and near-patient testing sorted the largest intervention effects.

Conclusion: this review emphasises the importance of physician education in optimising antibiotic use. Further research should focus on how to provide physicians with the relevant knowledge and tools, and when to supplement education with additional intervention elements. Feasibility should be included in this process

This record has no associated files available for download.

More information

Published date: December 2012
Organisations: Primary Care & Population Sciences, Psychology

Identifiers

Local EPrints ID: 347557
URI: http://eprints.soton.ac.uk/id/eprint/347557
ISSN: 0960-1643
PURE UUID: 41a180fc-6f55-41c0-9277-d3d07392e4d6

Catalogue record

Date deposited: 24 Jan 2013 11:35
Last modified: 25 Nov 2021 18:58

Export record

Altmetrics

Contributors

Author: A.W. van der Velden
Author: E.J. Pijpers
Author: M.M. Kuyvenhoven
Author: P. Little
Author: T.J.M. Verheij

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×