Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners2013
Effects on antibiotic dispensing rates of interventions to promote delayed prescribing for respiratory tract infections in primary care.
Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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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
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Electronic Health Record Nudges and Health Care Quality and Outcomes in Primary Care: A Systematic Review.JAMA network open · 2024Pooled it
- The effects of on-screen, point of care computer reminders on processes and outcomes of care.The Cochrane database of systematic reviews · 2009Pooled it
- Effectiveness and safety of electronically delivered prescribing feedback and decision support on antibiotic use for respiratory illness in primary care: REDUCE cluster randomised trial.BMJ (Clinical research ed.) · 2019Trial
- Trial
- Improving antibiotic prescribing in acute respiratory tract infections: cluster randomised trial from Norwegian general practice (prescription peer academic detailing (Rx-PAD) study).BMJ (Clinical research ed.) · 2013Trial
- How, why and when are delayed (back-up) antibiotic prescriptions used in primary care? A realist review integrating concepts of uncertainty in healthcare.BMC public health · 2024Review
- Trends in antibiotic prescribing in primary care out-of-hours doctors' services in Ireland.JAC-antimicrobial resistance · 2024Article
- Antibiotic treatment of respiratory tract infections in adults in Norwegian general practice.JAC-antimicrobial resistance · 2023Article
- A Novel GPPAS Model: Guiding the Implementation of Antimicrobial Stewardship in Primary Care Utilising Collaboration between General Practitioners and Community Pharmacists.Antibiotics (Basel, Switzerland) · 2022Article
- Evaluation of a multimodal intervention to promote rational antibiotic use in primary care.Antimicrobial resistance and infection control · 2021Article
- The Evidence-Based Development of an Intervention to Improve Clinical Health Literacy Practice.International journal of environmental research and public health · 2020Review
- Antibiotic Prescribing Quality in Out-of-Hours Primary Care and Critical Appraisal of Disease-Specific Quality Indicators.Antibiotics (Basel, Switzerland) · 2019Article
- Relationship between Maternal and First Year of Life Dispensations of Antibiotics and Antiasthmatics.Antibiotics (Basel, Switzerland) · 2018Article
- Prescribing antibiotics when the stakes are higher - do GPs prescribe less when patients are pregnant? A retrospective observational study.BJGP open · 2018Article
- Delayed antibiotic prescription for upper respiratory tract infections in children under primary care: Physicians' views.The European journal of general practice · 2017Article
- Using theory to explore facilitators and barriers to delayed prescribing in Australia: a qualitative study using the Theoretical Domains Framework and the Behaviour Change Wheel.BMC family practice · 2017Article
- Which treatment strategy for women with symptoms of urinary tract infection?BMJ (Clinical research ed.) · 2015Article
- Article
- Educational effectiveness, target, and content for prudent antibiotic use.BioMed research international · 2015Review
- Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem.Therapeutic advances in drug safety · 2014Review
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelayed antibiotic prescribing is an effective method of reducing the consumption of antibiotics for respiratory tract infections (RTIs). However, interventions to promote its use remain unexplored.
aimTo measure the effects of a GP educational intervention and a computer delayed-prescribing pop-up reminder on antibiotic-dispensing rates. The study also aimed to identify factors influencing GPs' decisions to issue delayed prescriptions and patients' decisions to fill their prescriptions. DESIGN AND
settingControlled trial nested within a cluster-randomised controlled trial in urban and rural practices in 11 counties in southern Norway.
methodEducational intervention and control groups were randomly populated from 81 continuing medical education groups. Within the intervention arm, 107 of the 156 participating GPs were assigned, based on the electronic patient-record system they used, to having a pop-up reminder installed on their computers. Data on prescribed and dispensed antibiotics from 1 year before, and 1 year during, the intervention were collected and linked.
resultsValid data were obtained from 328 GPs (75%). At baseline, 92.1% of prescriptions were filled at pharmacies. The effect of the educational intervention was a 1% reduction in approximated risk (risk ratio [RR] 0.99, 95% confidence interval [CI] = 0.96 to 1.01) of antibiotics being dispensed, while the combined effect of the educational and pop-up reminder intervention was a 4% reduction in approximated risk (RR 0.96, 95% CI = 0.94 to 0.98). In the pop-up intervention group, 11.0% of the prescriptions were issued as delayed prescriptions and 59.2% of these were filled. Upper RTI, sinusitis, and otitis gave highest odds for delayed prescribing and lowest odds for dispensing.
conclusionPromoting delayed prescribing among GPs results in a small decrease in antibiotic dispensing. The savings potential is greatest for upper RTI, sinusitis, and otitis.
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