ArticleJournal of general internal medicine2019
Behavioral Economics Interventions to Improve Outpatient Antibiotic Prescribing for Acute Respiratory Infections: a Cost-Effectiveness Analysis.
Article in Journal of general internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis 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.
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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.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Economic evaluation of antimicrobial stewardship in primary care: a systematic review and quality assessment.The Journal of antimicrobial chemotherapy · 2022Pooled it
- A Brief Educational Intervention to Increase ED Initiation of Buprenorphine for Opioid Use Disorder (OUD).Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2022Trial
- Estimating cost savings from reducing antibiotic overprescription in european general practices.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Mailed Audit and Feedback for Antibiotic Prescribing in Primary Care.JAMA network open · 2026Article
- Managing Resource Utilization Cost of Laboratory Tests for Patients on Chemotherapy in Johns Hopkins Aramco Healthcare.Global journal on quality and safety in healthcare · 2023Article
- Do Patients' Psychosocial Characteristics Impact Antibiotic Prescription Rates?Antibiotics (Basel, Switzerland) · 2023Article
- Implementation and outcomes of a clinician-directed intervention to improve antibiotic prescribing for acute respiratory tract infections within the Veterans' Affairs Healthcare System.Infection control and hospital epidemiology · 2023Review
- Educational Interventions to Reduce Prescription and Dispensing of Antibiotics in Primary Care: A Systematic Review of Economic Impact.Antibiotics (Basel, Switzerland) · 2022Review
- Effectiveness of behavioural economics-based interventions to improve colorectal cancer screening participation: A rapid systematic review of randomised controlled trials.Preventive medicine reports · 2022Review
- Behavioral Economics and Ambulatory Antibiotic Stewardship: A Narrative Review.Clinical therapeutics · 2021Review
- Choice architecture-based prescribing tool for TB preventive therapy: a pilot study in South Africa.Public health action · 2020Article
- Economic impact of clinical decision support interventions based on electronic health records.BMC health services research · 2020Review
- So Many Nudges, So Little Time: Can Cost-effectiveness Tell Us When It Is Worthwhile to Try to Change Provider Behavior?Journal of general internal medicine · 2019Article
- Using Behavioral Economics to Promote HIV Prevention for Key Populations.Journal of AIDS & clinical research · 2018Article
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Authors and funding
5 authors.
Funding
Abstract
backgroundBehavioral economics interventions have been shown to effectively reduce the rates of inappropriate antibiotic prescriptions for acute respiratory infections (ARIs).
objectiveTo determine the cost-effectiveness of three behavioral economic interventions designed to reduce inappropriate antibiotic prescriptions for ARIs.
designThirty-year Markov model from the US societal perspective with inputs derived from the literature and CDC surveillance data. SUBJECTS: Forty-five-year-old adults with signs and symptoms of ARI presenting to a healthcare provider.
interventions(1) Provider education on guidelines for the appropriate treatment of ARIs; (2) Suggested Alternatives, which utilizes computerized clinical decision support to suggest non-antibiotic treatment choices in lieu of antibiotics; (3) Accountable Justification, which mandates free-text justification into the patient's electronic health record when antibiotics are prescribed; and (4) Peer Comparison, which sends a periodic email to prescribers about his/her rate of inappropriate antibiotic prescribing relative to clinician colleagues. MAIN MEASURES: Discounted costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios. KEY
resultsEach intervention has lower costs but higher QALYs compared to provider education. Total costs for each intervention were $178.21, $173.22, $172.82, and $172.52, and total QALYs were 14.68, 14.73, 14.74, and 14.74 for the control, Suggested Alternatives, Accountable Justification, and Peer Comparison groups, respectively. Results were most sensitive to the quality-of-life of the uninfected state, and the likelihood and costs for antibiotic-associated adverse events.
conclusionsBehavioral economics interventions can be cost-effective strategies for reducing inappropriate antibiotic prescriptions by reducing healthcare resource utilization.
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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.