Trial reportQuality & safety in health care2007
What is the role of quality circles in strategies to optimise antibiotic prescribing? A pragmatic cluster-randomised controlled trial in primary care.
Trial report in Quality & safety in health care, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Tools developed and disseminated by guideline producers to promote the uptake of their guidelines.The Cochrane database of systematic reviews · 2016Pooled it
- Tailored interventions to address determinants of practice.The Cochrane database of systematic reviews · 2015Pooled it
- Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes.The Cochrane database of systematic reviews · 2010Pooled it
- Implementation fidelity in a multifaceted program to foster rational antibiotics use in primary care: an observational study.BMC medical research methodology · 2022Trial
- Effectiveness of multifaceted educational programme to reduce antibiotic dispensing in primary care: practice based randomised controlled trial.BMJ (Clinical research ed.) · 2012Trial
- Stemming the Tide of Antibiotic Resistance (STAR): a protocol for a trial of a complex intervention addressing the 'why' and 'how' of appropriate antibiotic prescribing in general practice.BMC family practice · 2009Trial
- Behavioral Nudges to Encourage Appropriate Antimicrobial Use Among Health Professionals in Uganda.Antibiotics (Basel, Switzerland) · 2024Article
- Improving antibiotic prescribing quality in out-of-hours primary care: a mixed-methods study using participatory action research.JAC-antimicrobial resistance · 2023Article
- Revisiting patient expectations and experiences of antibiotics in an era of antimicrobial resistance: Qualitative study.Health expectations : an international journal of public participation in health care and health policy · 2020Article
- Use of quality circles for primary care providers in 24 European countries: an online survey of European Society for Quality and Safety in family practice delegates.Scandinavian journal of primary health care · 2019Article
- Changing the Antibiotic Prescribing of general practice registrars: the ChAP study protocol for a prospective controlled study of a multimodal educational intervention.BMC family practice · 2016Article
- Improving the appropriateness of antimicrobial use in primary care after implementation of a local antimicrobial guide in both levels of care.European journal of clinical pharmacology · 2014Article
- Enabling factors for antibiotic prescribing for upper respiratory tract infections: perspectives of Lithuanian and Russian general practitioners.Upsala journal of medical sciences · 2013Article
- Effectiveness of physician-targeted interventions to improve antibiotic use for respiratory tract infections.The British journal of general practice : the journal of the Royal College of General Practitioners · 2012Review
- Resource use and costs of treating acute cough/lower respiratory tract infections in 13 European countries: results and challenges.The European journal of health economics : HEPAC : health economics in prevention and care · 2011Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the effect on antibiotic prescribing of an intervention in existing local quality circles promoting an evidence-based guideline for acute rhinosinusitis.
designA pragmatic cluster-randomised controlled trial comparing standard dissemination of the guideline by mail with an additional strategy using quality circles.
settingGeneral practice in Flanders, Belgium.
participantsGeneral practitioners (GPs) in 18 local quality circles were randomly allocated to two study arms. All GPs received the guideline by mail. GPs in the nine quality circles allocated to the intervention arm received an additional group intervention, which consisted of one self-led meeting using material introduced to the group moderator by a member of the research team.
main outcome measuresAdherence to the guideline was measured as differences in the proportion of antibiotic prescriptions, including the choice of antibiotic, between the two study arms after the intervention period. GPs registered their encounters with patients presenting with signs and symptoms of acute rhinosinusitis in a booklet designed for the study.
resultsA total of 75 doctors (29% of GPs in the participating quality circles) registered 408 consultations. In the intervention group, 56.9% of patients received an antibiotic compared with 58.3% in the control group. First-choice antibiotics were issued in 34.5% of antibiotic prescriptions in the intervention group compared with 29.4% in the control group. After adjusting for patient and GP characteristics, the ORadj for antibiotics prescribed in the intervention arm compared with the control arm was 0.63 (95% CI 0.29 to 1.37). There was no effect on the choice of antibiotic (ORadj 1.07, 95% CI 0.34 to 3.37).
conclusionA single intervention in quality circles of GPs integrated in the group's normal working procedure did not have a significant effect on the quality of antibiotic prescribing. More attention to the context and structure of primary care practice, and insight into the process of self-reflective learning may provide clues to optimise the effectiveness of quality circles.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.