Respiratory Tract Infections
Conditions
Keywords
Antibiotic, Prescribing behaviour, Guidelines, Respiratory tract infections, Non-antibiotic prescription
Brief summary
Respiratory tract infections are the most common indication for antibiotic prescribing in primary care. Several studies have shown a strong relationship between antibiotic use and bacterial resistance. The aim of this trial was to assess the long-term effect of a continuous education program on general practitioners antibiotic prescribing behaviour. 170 physicians were included in this study. Physicians randomized in the education group attended a two days seminar focused on evidence-based guidelines on antibiotic use in respiratory tract infections. The intervention was limited at physicians level and did not target the patients.
Interventions
OTHERExperimental: Training to antibiotic prescription
GPs assigned to the intervention group attended a two days didactic educational meeting on evidence-based guidelines for diagnosis and treatment of acute respiratory tract infection.
OTHERNo education on antibiotic prescription rules.
GPs assigned to control group received no specific recommendations on antibiotic prescription.
Sponsors
Henri Mondor University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* General practitioners practicing in three departments of the Parisian area in France * General practitioners attending a two days didactic educational meeting on evidence-based guidelines for diagnosis and treatment of acute respiratory tract infection.
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in the percentage of prescriptions containing an antibiotic between control and intervention groups (seminar on the treatment of respiratory tract infections). | Effect of the intervention 4 to 6 months after the educational training. | All prescriptions written by all general practitioners enrolled in the study were extracted each year from the French National Health System database. All data were compared to 2004 (baseline). Education group GPs attended a two-day seminar presenting evidence-based guidelines on antibiotic prescription in respiratory tract infections. The change (compared to baseline) in the percentage of prescriptions containing an antibiotic (antibiotic prescription rates) was compared between control and intervention groups. |
| Change in the cost of antibiotic prescription between control and intervention groups (seminar on the treatment of respiratory tract infections). | Effect of the intervention 4 to 6 months after the educational training. | All prescriptions written by all general practitioners enrolled in the study were extracted each year from the French National Health System database. All data were compared to 2004 (baseline). Education group GPs attended a two-day seminar presenting evidence-based guidelines on antibiotic prescription in respiratory tract infections. The change (compared to baseline) in the cost of antibiotic prescription was compared between control and intervention groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Symptomatic drug prescription rates | Effect of the intervention 28 to 30 months after the educational training. | Prescription rates of symptomatic drug for respiratory infections between both groups |
| Symptomatic drug cost. | Effect of the intervention 28 to 30 months after the educational training. | Cost of symptomatic drug between both groups |
| Long term antibiotic prescription rates | Effect of the intervention 28 to 30 months after the educational training. | Long term change in the percentage of antibiotic prescriptions between both groups |
| Effect of a seminar on problem-solving strategy on prescriptions. | Effect of the intervention 28 to 30 months after the educational training. | A second randomization was performed among the intervention group. In one subgroup, GPs attended an additional seminar on problem-solving strategies. Antibiotic prescription rates were compared between controls, evidence-based and problem-solving subgroups. Antibiotic cost was also compared between the both subgroups |
| Effect of patient age. | Effect of the intervention 28 to 30 months after the educational training. | Effect of patient age on antibiotic prescription between both groups |
| Long term antibiotic cost. | Effect of the intervention 28 to 30 months after the educational training. | Long term change in the cost of antibiotic prescriptions between both groups |
Countries
France
Outcome results
None listed