Influence of Electronics on Antibiotic Prescription Rates Appears Limited

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Antibiotic overuse is a problem that complicates treatment options.
Antibiotic overuse is a problem that complicates treatment options.

NEW ORLEANS -- Interventions that utilize social motivations and pressure appear better at motivating physicians to reduce antibiotic overuse than electronics or other methods, according to research presented at IDWeek 2016.

Jeffrey Linder, MD, MPH, of Brigham and Women's Hospital/Harvard Medical School and colleagues presented research derived from 47 primary care practices that employed 3 behavioral interventions aimed at reducing antibiotic use. 

The first intervention employed electronic order sets, which prompted the physician to consider alternatives to the prescribed antibiotic, a second prompted clinicians to enter written “justifications” for antibiotic prescriptions, and a third used monthly emails that compared prescribers to their colleagues, sending emails with wording such as "you are a top performer."

Dr Linder and colleagues previously reported on their findings during the intervention itself, and these results were 18 months after the intervention ended. 

"We saw a persistent significant change in antibiotic prescriptions in the peer comparision group," Dr Linder said, but other interventions noted that the other methods did not continue to have a significant impact on prescribing trends.

The researchers noted that “the adjusted antibiotic prescribing rate during the 18-month intervention period was 17% (95% confidence interval [CI], 14% to 21%) and during the 5-month post-intervention period was 15% (95% CI, 11% to 19%; =.20).” The researchers noted that the interventions did not lead to a significant change in prescribing rates, but that the comparison prompt was the most effective.

During his presentation, Dr Linder stressed the importance of finding methods to reduce inappropriate uses of antibiotics.

Reference

1. Linder J, Meeker D, Fox C, et al.  Durability of benefits of behavioral interventions on antibiotic prescribing in primary care: Follow-up from a cluster randomized trial. Presented at: ID Week 2016. October 26-30, 2016. New Orleans.  Abstract 75.

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