ArticleBMJ open2016
Prescriber preferences for behavioural economics interventions to improve treatment of acute respiratory infections: a discrete choice experiment.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01454947 (Use of Behavioral Economics to Improve Treatment of Acute Respiratory Infections), which is not on this map. Cited by 12 papers, 4 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.
Use of Behavioral Economics to Improve Treatment of Acute Respiratory Infections (Main Study)
Who cites it
12 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Indication documentation and indication-based prescribing within electronic prescribing systems: a systematic review and narrative synthesis.BMJ quality & safety · 2023Pooled it
- Effectiveness of interventions targeting antibiotic use in long-term aged care facilities: a systematic review and meta-analysis.BMJ open · 2020Pooled it
- Behavioral Economics Interventions in Clinical Decision Support Systems.Yearbook of medical informatics · 2018Pooled it
- Application of discrete choice experiments to enhance stakeholder engagement as a strategy for advancing implementation: a systematic review.Implementation science : IS · 2017Pooled it
- Physician Antibiotic Prescribing Preferences in Community Acquired Pneumonia and Complicated Urinary Tract Infections: A National Discrete Choice Experiment.Open forum infectious diseases · 2026Article
- Implementation mapping to plan for the Supraglottic Airway for Resuscitation (SUGAR) trial.Implementation science communications · 2024Article
- It's about the patients: Practical antibiotic stewardship in outpatient settings in the United States.Frontiers in medicine · 2022Review
- Behavioral Economics and Ambulatory Antibiotic Stewardship: A Narrative Review.Clinical therapeutics · 2021Review
- Community stakeholder preferences for evidence-based practice implementation strategies in behavioral health: a best-worst scaling choice experiment.BMC psychiatry · 2021Article
- Systematic review and validity assessment of methods used in discrete choice experiments of primary healthcare professionals.Health economics review · 2020Review
- The clinician crowdsourcing challenge: using participatory design to seed implementation strategies.Implementation science : IS · 2019Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
objectiveTo elicit prescribers' preferences for behavioural economics interventions designed to reduce inappropriate antibiotic prescribing, and compare these to actual behaviour.
designDiscrete choice experiment (DCE).
setting47 primary care centres in Boston and Los Angeles.
participants234 primary care providers, with an average 20 years of practice. MAIN OUTCOMES AND MEASURES: Results of a behavioural economic intervention trial were compared to prescribers' stated preferences for the same interventions relative to monetary and time rewards for improved prescribing outcomes. In the randomised controlled trial (RCT) component, the 3 computerised prescription order entry-triggered interventions studied included: Suggested Alternatives (SA), an alert that populated non-antibiotic treatment options if an inappropriate antibiotic was prescribed; Accountable Justifications (JA), which prompted the prescriber to enter a justification for an inappropriately prescribed antibiotic that would then be documented in the patient's chart; and Peer Comparison (PC), an email periodically sent to each prescriber comparing his/her antibiotic prescribing rate with those who had the lowest rates of inappropriate antibiotic prescribing. A DCE study component was administered to determine whether prescribers felt SA, JA, PC, pay-for-performance or additional clinic time would most effectively reduce their inappropriate antibiotic prescribing. Willingness-to-pay (WTP) was calculated for each intervention.
resultsIn the RCT, PC and JA were found to be the most effective interventions to reduce inappropriate antibiotic prescribing, whereas SA was not significantly different from controls. In the DCE however, regardless of treatment intervention received during the RCT, prescribers overwhelmingly preferred SA, followed by PC, then JA. WTP estimates indicated that each intervention would be significantly cheaper to implement than pay-for-performance incentives of $200/month.
conclusionsPrescribing behaviour and stated preferences are not concordant, suggesting that relying on stated preferences alone to inform intervention design may eliminate effective interventions. TRIAL REGISTRATION NUMBER: NCT01454947; Results.
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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.