Literature DB >> 10555250

Long-lasting improvement in general practitioners' prescribing of antibiotics by means of medical audit.

A P Munck1, B Gahrn-Hansen, P Søgaard, J Søgaard.   

Abstract

OBJECTIVE: To evaluate the usefulness of medical audit of GPs' antibiotic prescription habits.
DESIGN: Medical audit according to the APO method. Registration of antibiotic prescriptions for respiratory tract infections during a 3 year period. Intervention with courses, visits to the laboratory, and distribution of recommendations concerning diagnosis and treatment of respiratory infections.
SETTING: 24 Danish GPs in cooperation with Audit Project Odense (APO) and Department of Clinical Microbiology, Odense University Hospital. 207 GPs acted as controls. MAIN OUTCOME MEASURES: Changes in the number of antibiotic prescriptions and in the penicillin/broad-spectrum antibiotic ratio.
RESULTS: The proportion of antibiotic prescriptions was reduced during the investigation period, but a similar reduction was found in the control groups. Only for acute sinusitis was a lasting decrease not found in the control groups recorded. The penicillin/broad-spectrum antibiotic ratio increased in the intervention group (1.33 in 1992, 1.94 in 1993 and 2.70 in 1995). This increase was significantly higher than in the control groups. The change was seen for acute sinusitis, bronchitis, and pneumonia, but not for acute otitis media or acute tonsillitis. The changes induced from 1992 to 1993 were maintained or increased from 1993 to 1995 although the educational measures had stopped.
CONCLUSION: Medical audit according to the APO method is a useful tool for inducing and maintaining desirable changes in GPs' prescription habits.

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Year:  1999        PMID: 10555250     DOI: 10.1080/028134399750002629

Source DB:  PubMed          Journal:  Scand J Prim Health Care        ISSN: 0281-3432            Impact factor:   2.581


  13 in total

Review 1.  Effectiveness of physician-targeted interventions to improve antibiotic use for respiratory tract infections.

Authors:  Alike W van der Velden; Eefje J Pijpers; Marijke M Kuyvenhoven; Sarah K G Tonkin-Crine; Paul Little; Theo J M Verheij
Journal:  Br J Gen Pract       Date:  2012-12       Impact factor: 5.386

2.  Can the APO method be used for measuring soft data?: a pilot study.

Authors:  Eva Lena Strandberg; Ingvar Ovhed; Anders Håkansson; Margareta Troein
Journal:  Scand J Prim Health Care       Date:  2011-12       Impact factor: 2.581

Review 3.  Interventions to improve antibiotic prescribing practices in ambulatory care.

Authors:  S R Arnold; S E Straus
Journal:  Cochrane Database Syst Rev       Date:  2005-10-19

4.  What is the role of quality circles in strategies to optimise antibiotic prescribing? A pragmatic cluster-randomised controlled trial in primary care.

Authors:  M L van Driel; S Coenen; K Dirven; J Lobbestael; I Janssens; P Van Royen; F M Haaijer-Ruskamp; M De Meyere; J De Maeseneer; T Christiaens
Journal:  Qual Saf Health Care       Date:  2007-06

5.  Can antibiotic prescriptions in respiratory tract infections be improved? A cluster-randomized educational intervention in general practice--the Prescription Peer Academic Detailing (Rx-PAD) Study [NCT00272155].

Authors:  Svein Gjelstad; Arne Fetveit; Jørund Straand; Ingvild Dalen; Sture Rognstad; Morten Lindbaek
Journal:  BMC Health Serv Res       Date:  2006-06-15       Impact factor: 2.655

6.  The meaning of quality work from the general practitioner's perspective: an interview study.

Authors:  Eva Lena Strandberg; Ingvar Ovhed; Anders Håkansson; Margareta Troein
Journal:  BMC Fam Pract       Date:  2006-10-19       Impact factor: 2.497

7.  Combining physical and virtual contexts through augmented reality: design and evaluation of a prototype using a drug box as a marker for antibiotic training.

Authors:  Sokratis Nifakos; Tanja Tomson; Nabil Zary
Journal:  PeerJ       Date:  2014-12-16       Impact factor: 2.984

8.  Peer academic detailing on use of antibiotics in acute respiratory tract infections. A controlled study in an urban Norwegian out-of-hours service.

Authors:  Roar Dyrkorn; Svein Gjelstad; Ketil Arne Espnes; Morten Lindbæk
Journal:  Scand J Prim Health Care       Date:  2016-04-07       Impact factor: 2.581

9.  Assessment of a new algorithm in the management of acute respiratory tract infections in children.

Authors:  Seyed Ahmad Tabatabaei; Seyed Alireza Fahimzad; Ahmad Reza Shamshiri; Farideh Shiva; Shadab Salehpor; Shirin Sayyahfar; Ghamartag Khanbabaei; Shahnaz Armin; Sedigheh Rafil Tabatabaei; Alireza Khatami; Maryam Kadivar
Journal:  J Res Med Sci       Date:  2012-02       Impact factor: 1.852

10.  Improving antibiotic prescribing in acute respiratory tract infections: cluster randomised trial from Norwegian general practice (prescription peer academic detailing (Rx-PAD) study).

Authors:  Svein Gjelstad; Sigurd Høye; Jørund Straand; Mette Brekke; Ingvild Dalen; Morten Lindbæk
Journal:  BMJ       Date:  2013-07-26
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