Trial reportCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2012
Training family physicians in shared decision-making to reduce the overuse of antibiotics in acute respiratory infections: a cluster randomized trial.
Trial report in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 101 papers, 20 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
DECISION+: Une Formation Pour Les médecins de Famille Sur la Prise de décision partagée Afin d'Optimiser Les décisions Cliniques Concernant l'Utilisation d'Antibiotiques Pour Les Infections aiguës Des Voies Respiratoires (IAVR)
Wiki Head CT Choice Study: Adaptation of Two Decision Aids to Support Shared Decision Making About Performing a Head CT for Adult and Pediatric Victims of Mild Traumatic Brain Injury
Who cites it
101 citing papers in PubMed, 20 syntheses or guidelines pooled it, 228 citations in OpenAlex.
- A systematic review of shared decision making training programs for general practitioners.BMC medical education · 2024Pooled it
- Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2024Pooled it
- Improving healthcare professionals' interactions with patients to tackle antimicrobial resistance: a systematic review of interventions, barriers, and facilitators.Frontiers in public health · 2024Pooled it
- Pooled it
- Engaging patients in de-implementation interventions to reduce low-value clinical care: a systematic review and meta-analysis.BMC medicine · 2020Pooled it
- Pooled it
- Digital Learning to Improve Safe and Effective Prescribing: A Systematic Review.Clinical pharmacology and therapeutics · 2019Pooled it
- Health Professions Digital Education on Antibiotic Management: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration.Journal of medical Internet research · 2019Pooled it
- Measures Used to Assess the Impact of Interventions to Reduce Low-Value Care: a Systematic Review.Journal of general internal medicine · 2019Pooled it
- Patient Education and Continuing Medical Education to Promote Shared Decision-Making. A Systematic Literature Review.International journal of environmental research and public health · 2019Pooled it
- Strategies to evaluate healthcare provider trainings in shared decision-making (SDM): a systematic review of evaluation studies.BMJ open · 2019Pooled it
- Impact of decision aids used during clinical encounters on clinician outcomes and consultation length: a systematic review.BMJ quality & safety · 2019Pooled it
- Online Digital Education for Postregistration Training of Medical Doctors: Systematic Review by the Digital Health Education Collaboration.Journal of medical Internet research · 2019Pooled it
- Systematic review of shared decision-making in surgery.The British journal of surgery · 2018Pooled it
- Interventions for increasing the use of shared decision making by healthcare professionals.The Cochrane database of systematic reviews · 2018Pooled it
- Clinician-targeted interventions to influence antibiotic prescribing behaviour for acute respiratory infections in primary care: an overview of systematic reviews.The Cochrane database of systematic reviews · 2017Pooled it
- Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2017Pooled it
- Written information for patients (or parents of child patients) to reduce the use of antibiotics for acute upper respiratory tract infections in primary care.The Cochrane database of systematic reviews · 2016Pooled it
- Interventions to facilitate shared decision making to address antibiotic use for acute respiratory infections in primary care.The Cochrane database of systematic reviews · 2015Pooled it
- Effects of improved patient participation in primary care on health-related outcomes: a systematic review.Family practice · 2013Pooled it
41 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFew interventions have proven effective in reducing the overuse of antibiotics for acute respiratory infections. We evaluated the effect of DECISION+2, a shared decision-making training program, on the percentage of patients who decided to take antibiotics after consultation with a physician or resident.
methodsWe performed a randomized trial, clustered at the level of family practice teaching unit, with 2 study arms: DECISION+2 and control. The DECISION+2 training program included a 2-hour online tutorial followed by a 2-hour interactive seminar about shared decision-making. The primary outcome was the proportion of patients who decided to use antibiotics immediately after consultation. We also recorded patients' perception that shared decision-making had occurred. Two weeks after the initial consultation, we assessed patients' adherence to the decision, repeat consultation, decisional regret and quality of life.
resultsWe compared outcomes among 181 patients who consulted 77 physicians in 5 family practice teaching units in the DECISION+2 group, and 178 patients who consulted 72 physicians in 4 family practice teaching units in the control group. The percentage of patients who decided to use antibiotics after consultation was 52.2% in the control group and 27.2% in the DECISION+2 group (absolute difference 25.0%, adjusted relative risk 0.48, 95% confidence interval 0.34-0.68). DECISION+2 was associated with patients taking a more active role in decision-making (Z = 3.9, p < 0.001). Patient outcomes 2 weeks after consultation were similar in both groups.
interpretationThe shared decision-making program DECISION+2 enhanced patient participation in decision-making and led to fewer patients deciding to use antibiotics for acute respiratory infections. This reduction did not have a negative effect on patient outcomes 2 weeks after consultation. ClinicalTrials.gov trial register no. NCT01116076.
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What OpenQuestion holds
Registered trials
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.