Interventions to Reduce Inappropriate Antibiotic Prescribing May Need to Be Applied Long-Term — Physician’s First Watch

Medical News |
October 11, 2017

Interventions to Reduce Inappropriate Antibiotic Prescribing May Need to Be Applied Long-Term

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Stopping behavioral interventions aimed at reducing inappropriate antibiotic prescribing might cause a rebound in prescribing rates, suggests a follow-up study in JAMA.

In the original randomized trial, two interventions — "accountable justification" and "peer comparison" — were associated with reductions in inappropriate antibiotic prescribing for adults with acute respiratory infections. (With accountable justification, clinicians were prompted by their electronic health record to write a justification for prescribing antibiotics; with peer comparison, clinicians received emails that ranked their inappropriate prescribing rate against other participants' rates.)

Now, researchers have examined prescribing rates in the 12 months after the interventions were stopped. They found that inappropriate prescribing increased from 6.1% to 10.2% in the accountable justification group, and from 4.8% to 6.3% in the peer comparison group. The peer comparison group still had better prescribing rates than a control group, while the accountable justification group did not.

The researchers conclude that "institutions exploring behavioral interventions to influence clinician decision making should consider applying them long-term."

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