Carl Llor1, Lars Bjerrum2, José M Molero3, Ana Moragas4, Beatriz González López-Valcárcel5, M José Monedero6, Manuel Gómez7, Marina Cid8, Juan de Dios Alcántara9, Josep M Cots10, Joana M Ribas11, Guillermo García12, Jesús Ortega13, Vicenta Pineda14, Gloria Guerra15, Susana Munuera16. 1. Via Roma Health Centre, Barcelona, Spain. 2. Section of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. 3. San Andrés Health Centre, Madrid, Spain. 4. University Rovira i Virgili, Jaume I Health Centre, Tarragona, Spain. 5. Department of Quantitative Methods for Economics and Management, University of Las Palmas, Las Palmas de Gran Canaria, Spain. 6. Rafalalena Health Centre, Castellón, Spain. 7. Mirasierra Health Centre, Madrid, Spain. 8. Teis Health Centre, Vigo, Spain. 9. Bollulos Par del Condado Health Centre, Huelva, Spain. 10. University of Barcelona, La Marina Health Centre, Barcelona, Spain. 11. Hospital Sant Llàtzer, Palma, Spain. 12. La Calzada II Health Centre, Gijón, Spain. 13. Rincón de Soto Health Centre, La Rioja, Spain. 14. Serrería I Health Centre, Valencia, Spain. 15. Escaleritas Health Centre, Las Palmas de Gran Canaria, Spain. 16. Son Pisà Health Centre, Palma, Spain.
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 22 247 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.
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 22 247 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.
Authors: Jun Rong Jeffrey Neo; Jeff Niederdeppe; Ole Vielemeyer; Brandyn Lau; Michelle Demetres; Hessam Sadatsafavi Journal: J Med Syst Date: 2020-02-10 Impact factor: 4.460
Authors: J M Molero; M Gómez; G Guerra; J D Alcántara; J Ortega; G García; V Pineda; S Munuera; M Cid; M J Monedero; J M Ribas; J M Cots; A Moragas; L Bjerrum; C Llor Journal: Rev Esp Quimioter Date: 2018-11-05 Impact factor: 1.553
Authors: Adolfo Figueiras; Paula López-Vázquez; Cristian Gonzalez-Gonzalez; Juan Manuel Vázquez-Lago; María Piñeiro-Lamas; Ana López-Durán; Coro Sánchez; María Teresa Herdeiro; Maruxa Zapata-Cachafeiro Journal: Antimicrob Resist Infect Control Date: 2020-12-07 Impact factor: 4.887
Authors: Rocío Fernández-Urrusuno; Carmen Marina Meseguer Barros; Regina Sandra Benavente Cantalejo; Elena Hevia; Carmen Serrano Martino; Aranzazu Irastorza Aldasoro; Juan Limón Mora; Antonio López Navas; Beatriz Pascual de la Pisa Journal: PLoS One Date: 2020-05-15 Impact factor: 3.240