Effect of a Feedback Visit and a Clinical Decision Support System Based on Antibiotic Prescription Audit in Primary Care: Multiarm Cluster-Randomized Controlled Trial
2024

Impact of Feedback Visits and Decision Support on Antibiotic Prescriptions

Sample size: 2501 publication 10 minutes Evidence: high

Author Information

Author(s): Zhuang Yan, François Mathilde, Carney Greg, MacBride-Stewart Sean, Jeanmougin Pauline, Larramendy Stéphanie, Fournier Jean-Pascal, Gaultier Aurélie, Rat Cédric

Primary Institution: Nantes University

Hypothesis

This study aimed to evaluate the effect of multifaceted antibiotic stewardship interventions on inappropriate systemic antibiotic prescriptions in primary care.

Conclusion

The study found that a visit by a health insurance representative combined with feedback and a clinical decision support system led to a 4.4% reduction in systemic antibiotic prescriptions over 12 months.

Supporting Evidence

  • The mean volume of systemic antibiotics per GP decreased by 219.2 defined daily doses in the CDSS-based visit group compared to the control group.
  • The decrease in antibiotic prescriptions was not significantly different between the standard visit group and the control group.
  • Overall, the intervention led to a 4.4% reduction in antibiotic prescriptions.

Takeaway

Doctors who got help and feedback on their antibiotic prescriptions gave out fewer antibiotics, which is good for fighting infections.

Methodology

An open-label, cluster-randomized controlled trial was conducted with 2501 general practitioners in western France, comparing two interventions against a control group.

Potential Biases

Potential bias due to the lack of blinding for GPs regarding their participation in the study.

Limitations

The study lacked data on the actual use of the clinical decision support system by GPs and could not assess the sustainability of the intervention's effects beyond 12 months.

Participant Demographics

43.9% of the participants were women, with a mean age distribution across various age groups.

Statistical Information

P-Value

<0.001

Confidence Interval

95% CI −339.5 to −98.8

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.2196/60535

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