Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10228
Title: Reducing early career general practitioners' antibiotic prescribing for respiratory tract infections: a pragmatic prospective non-randomised controlled trial.
Authors: Magin, Parker
Tapley, Amanda
Morgan, Simon
Davis, Joshua S
McElduff, Patrick
Yardley, Lucy
Henderson, Kim
Dallas, Anthea
McArthur, Lawrie
Mulquiney, Katie
Davey, Andrew
Little, Paul
Spike, Neil
van Driel, Mieke L
Affiliation: School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.. NSW & ACT Research and Evaluation Unit, GP Synergy Regional Training Organization, Newcastle, Australia..
School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.. NSW & ACT Research and Evaluation Unit, GP Synergy Regional Training Organization, Newcastle, Australia..
Elermore Vale General Practice, Elermore Vale, Australia..
School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.. Menzies School of Health Research, Royal Darwin Hospital Campus, Casuarina, Australia.. John Hunter Hospital, New Lambton Heights, Australia..
School of Medicine and Public Health, University of Newcastle, Newcastle, Australia..
Centre for Applications of Health Psychology, University of Southampton, Southampton, UK..
School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.. NSW & ACT Research and Evaluation Unit, GP Synergy Regional Training Organization, Newcastle, Australia..
University of Notre Dame, Sydney, Australia..
Department of General Practice, University of Adelaide, Adelaide, Australia..
School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.. NSW & ACT Research and Evaluation Unit, GP Synergy Regional Training Organization, Newcastle, Australia..
School of Medicine and Public Health, University of Newcastle, Newcastle, Australia..
Primary Care & Population Sciences Academic Units, University of Southampton, Southampton, UK..
Department of General Practice, University of Melbourne, Melbourne, Australia.. Eastern Victoria General Practice Training, Melbourne, Australia..
Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Australia..
Issue Date: 16-Jan-2018
Citation: Family practice 2018-01-16; 35(1): 53-60
Abstract: Inappropriate antibiotic prescription and consequent antibacterial resistance is a major threat to healthcare. To evaluate the efficacy of a multifaceted intervention in reducing early career general practitioners' (GPs') antibiotic prescribing for upper respiratory tract infections (URTIs) and acute bronchitis/bronchiolitis. A pragmatic non-randomized trial employing a non-equivalent control group design nested within an existing cohort study of GP registrars' (trainees') clinical practice. The intervention included access to online modules (covering the rationale of current clinical guidelines recommending non-prescription of antibiotics for URTI and bronchitis/bronchiolitis, and communication skills in management of acute bronchitis) followed by a face-to-face educational session. The intervention was delivered to registrars (and their supervisors) in two of Australia's seventeen regional GP training providers (RTPs). Three other RTPs were the control group. Outcomes were proportion of registrars' URTI consultations and bronchitis/bronchiolitis consultations prescribed antibiotics. Intention-to-treat analyses employed logistic regression within a Generalised Estimating Equation framework, adjusted for relevant independent variables. The predictors of interest were time; treatment group; and an interaction term for time-by-treatment group. The P value associated with an interaction term determined statistically significant differences in antibiotic prescribing. Analyses include data of 217 intervention RTPs' and 311 control RTPs' registrars. There was no significant reduction in antibiotic prescribing for URTIs. For bronchitis/bronchiolitis, a significant reduction (interaction P value = 0.024) remained true for analysis adjusted for independent variables (P value = 0.040). The adjusted absolute reduction in prescribing was 15.8% (95% CI: 4.2%-27.5%). A multifaceted intervention reduced antibiotic prescribing for bronchitis/bronchiolitis but not URTIs.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10228
DOI: 10.1093/fampra/cmx070
Type: Journal Article
Subjects: Antibacterial agents
family practice
general practice
inappropriate prescribing
physician practice patterns
respiratory tract infections
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