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Theory-based interventions to reduce prescription of antibiotics-a randomized controlled trial in Sweden

Milos, Veronica LU ; Jakobsson, Ulf LU ; Westerlund, Tommy; Melander, Eva; Mölstad, Sigvard LU and Midlöv, Patrik LU (2013) In Family Practice 30(6). p.634-640
Abstract
Background. Upper respiratory tract infections (URTIs) are the most common reason for consulting a GP and for receiving an antibiotic prescription, although evidence shows poor benefit but rather increasing antibiotic resistance. Interventions addressing physicians have to take into consideration the complexity of prescribing behaviour. Objective. To study whether interventions based on behavioural theories can reduce the prescribing of antibiotics against URTIs in primary care. Setting and subjects. GPs at 19 public primary health care centres in southern Sweden. Methods. We performed a randomized controlled study using two behavioural theory-based interventions, the persuasive communication intervention (PCI) and the graded task... (More)
Background. Upper respiratory tract infections (URTIs) are the most common reason for consulting a GP and for receiving an antibiotic prescription, although evidence shows poor benefit but rather increasing antibiotic resistance. Interventions addressing physicians have to take into consideration the complexity of prescribing behaviour. Objective. To study whether interventions based on behavioural theories can reduce the prescribing of antibiotics against URTIs in primary care. Setting and subjects. GPs at 19 public primary health care centres in southern Sweden. Methods. We performed a randomized controlled study using two behavioural theory-based interventions, the persuasive communication intervention (PCI) and the graded task intervention (GTI), which emerged from social cognitive theory and operant learning theory. GPs were randomized to a control group or one of two intervention groups (PCI and GTI). Main outcome measures. Changes in the rate of prescription of antibiotics against URTIs in primary care patients of all ages and in patients aged 0-6 years. Results. No significant differences were seen in the prescription rates before and after the interventions when patients of all ages were analysed together. However, for patients aged 0-6 years, there was a significant lower prescription rate in the PCI group (P = 0.037), but not the GTI group, after intervention. Conclusion. Theory-based interventions have limited impact on reducing the prescription of antibiotics against URTIs in primary care. Future studies are needed to draw firm conclusions about their effects. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Antibiotics, behavioural change interventions, primary health care, upper respiratory tract infections
in
Family Practice
volume
30
issue
6
pages
634 - 640
publisher
Oxford University Press
external identifiers
  • wos:000327511200005
  • scopus:84888175010
ISSN
1460-2229
DOI
10.1093/fampra/cmt043
language
English
LU publication?
yes
id
6b73864f-dac7-4e2e-b7ca-9aa94bf91fc6 (old id 4273362)
date added to LUP
2014-02-10 12:25:53
date last changed
2019-01-06 04:08:51
@article{6b73864f-dac7-4e2e-b7ca-9aa94bf91fc6,
  abstract     = {Background. Upper respiratory tract infections (URTIs) are the most common reason for consulting a GP and for receiving an antibiotic prescription, although evidence shows poor benefit but rather increasing antibiotic resistance. Interventions addressing physicians have to take into consideration the complexity of prescribing behaviour. Objective. To study whether interventions based on behavioural theories can reduce the prescribing of antibiotics against URTIs in primary care. Setting and subjects. GPs at 19 public primary health care centres in southern Sweden. Methods. We performed a randomized controlled study using two behavioural theory-based interventions, the persuasive communication intervention (PCI) and the graded task intervention (GTI), which emerged from social cognitive theory and operant learning theory. GPs were randomized to a control group or one of two intervention groups (PCI and GTI). Main outcome measures. Changes in the rate of prescription of antibiotics against URTIs in primary care patients of all ages and in patients aged 0-6 years. Results. No significant differences were seen in the prescription rates before and after the interventions when patients of all ages were analysed together. However, for patients aged 0-6 years, there was a significant lower prescription rate in the PCI group (P = 0.037), but not the GTI group, after intervention. Conclusion. Theory-based interventions have limited impact on reducing the prescription of antibiotics against URTIs in primary care. Future studies are needed to draw firm conclusions about their effects.},
  author       = {Milos, Veronica and Jakobsson, Ulf and Westerlund, Tommy and Melander, Eva and Mölstad, Sigvard and Midlöv, Patrik},
  issn         = {1460-2229},
  keyword      = {Antibiotics,behavioural change interventions,primary health care,upper respiratory tract infections},
  language     = {eng},
  number       = {6},
  pages        = {634--640},
  publisher    = {Oxford University Press},
  series       = {Family Practice},
  title        = {Theory-based interventions to reduce prescription of antibiotics-a randomized controlled trial in Sweden},
  url          = {http://dx.doi.org/10.1093/fampra/cmt043},
  volume       = {30},
  year         = {2013},
}