Let’s Talk About Antibiotics: a randomised trial of two interventions to reduce antibiotic misuse

Goggin, K; Hurley, EA; Lee, BR; Bradley-Ewing, A; Bickford, C; Pina, K; de Miranda, ED; Yu, D; Weltmer, K; Linnemayr, S; Butler, CC; Newland, JG; Myers, AL

Journal article

Let’s Talk About Antibiotics: a randomised trial of two interventions to reduce antibiotic misuse

Abstract:: BACKGROUND: Children with acute respiratory tract infections (ARTIs) receive ≈11.4 million unnecessary antibiotic prescriptions annually. A noted contributor is inadequate parent-clinician communication, however, efforts to reduce overprescribing have only indirectly targeted communication or been impractical. OBJECTIVES: Compare two feasible (higher vs lower intensity) interventions for enhancing parent-clinician communication on the rate of inappropriate antibiotic prescribing. DESIGN: Multisite, parallel group, cluster randomised comparative effectiveness trial. Data collected between March 2017 and March 2019. SETTING: Academic and private practice outpatient clinics. PARTICIPANTS: Clinicians (n=41, 85% of eligible approached) and 1599 parent-child dyads (ages 1-5 years with ARTI symptoms, 71% of eligible approached). INTERVENTIONS: All clinicians received 20 min ARTI diagnosis and treatment education. Higher intensity clinicians received an additional 50 min communication skills training. All parents viewed a 90 second antibiotic education video. MAIN OUTCOMES AND MEASURES: Inappropriate antibiotic treatment was assessed via blinded medical record review by study clinicians and a priori defined as prescriptions for the wrong diagnosis or use of the wrong agent. Secondary outcomes were revisits, adverse drug reactions (both assessed 2 weeks after the visit) and parent ratings of provider communication, shared decision-making and visit satisfaction (assessed at end of the visit on Likert-type scales). RESULTS: Most clinicians completed the study (n=38, 93%), were doctors (n=25, 66%), female (n=30, 78%) and averaged 8 years in practice. All parent-child dyad provided data for the main outcome (n=855 (54%) male, n=1043 (53%) CONCLUSIONS AND RELEVANCE: Rate of inappropriate prescribing was low in both arms. Clinician education coupled with parent education may be sufficient to yield low inappropriate antibiotic prescribing rates. The absence of a significant difference between groups indicates that communication principles previously thought to drive inappropriate prescribing may need to be re-examined or may not have as much of an impact in practices where prescribing has improved in recent years. TRIAL REGISTRATION NUMBER: NCT03037112

Publication status:: Published

Peer review status:: Peer reviewed

Actions

Email

Email this record

Send the bibliographic details of this record to your email address.

Your Email
Please enter the email address that the record information will be sent to.

-
Your message (optional)
Please add any additional information to be included within the email.
Share
Cite

Cite this record

APA Style

Goggin, K., Hurley, E. A., Lee, B. R., Bradley-Ewing, A., Bickford, C., Pina, K., de Miranda, E. D., Yu, D., Weltmer, K., Linnemayr, S., Butler, C. C., Newland, J. G., & Myers, A. L. (2022). Let’s Talk About Antibiotics: a randomised trial of two interventions to reduce antibiotic misuse. BMJ Open, 12(11), e049258–e049258.

MLA Style

Goggin, K, et al. “Let’s Talk About Antibiotics: a Randomised Trial of Two Interventions to Reduce Antibiotic Misuse.” BMJ Open, vol. 12, no. 11, 2022, pp. e049258–e049258.

Chicago Style

Goggin, K, EA Hurley, BR Lee, et al. 2022. “Let’s Talk About Antibiotics: a Randomised Trial of Two Interventions to Reduce Antibiotic Misuse.” BMJ Open 12 (11): e049258–e049258.
Print