Long Term Effect of General Practitioner Education on Antibiotic Prescribing

Not Applicable

• Conditions: Respiratory Tract Infections
• Interventions: Other: No education on antibiotic prescription rules.

• Registration Number: NCT01107223
• Lead Sponsor: Henri Mondor University Hospital

Brief Summary

Respiratory tract infections are the most common indication for antibiotic prescribing in primary care. Several studies have shown a strong relationship between antibiotic use and bacterial resistance. The aim of this trial was to assess the long-term effect of a continuous education program on general practitioners antibiotic prescribing behaviour. 170 physicians were included in this study. Physicians randomized in the education group attended a two days seminar focused on evidence-based guidelines on antibiotic use in respiratory tract infections. The intervention was limited at physicians level and did not target the patients.

Detailed Description

Not available

Study Timeline

• Study Start: 2004-09
• Primary Completion: 2009-04
• Status Verified: 2010-02
• Study First Submitted: 2010-03-04
• Study Completion: 2010-04
• Study First Submitted QC: 2010-04-19
• Last Update Submitted: 2010-04-19
• Study First Posted: 2010-04-20
• Last Update Posted: 2010-04-20

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 170

Inclusion Criteria

• General practitioners practicing in three departments of the Parisian area in France
• General practitioners attending a two days didactic educational meeting on evidence-based guidelines for diagnosis and treatment of acute respiratory tract infection.

Exclusion Criteria

• None

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
control	No education on antibiotic prescription rules.	-

Primary Outcome Measures

Name	Time	Method
Change in the percentage of prescriptions containing an antibiotic between control and intervention groups (seminar on the treatment of respiratory tract infections).	Effect of the intervention 4 to 6 months after the educational training.	All prescriptions written by all general practitioners enrolled in the study were extracted each year from the French National Health System database. All data were compared to 2004 (baseline). Education group GPs attended a two-day seminar presenting evidence-based guidelines on antibiotic prescription in respiratory tract infections. The change (compared to baseline) in the percentage of prescriptions containing an antibiotic (antibiotic prescription rates) was compared between control and intervention groups.
Change in the cost of antibiotic prescription between control and intervention groups (seminar on the treatment of respiratory tract infections).	Effect of the intervention 4 to 6 months after the educational training.	All prescriptions written by all general practitioners enrolled in the study were extracted each year from the French National Health System database. All data were compared to 2004 (baseline). Education group GPs attended a two-day seminar presenting evidence-based guidelines on antibiotic prescription in respiratory tract infections. The change (compared to baseline) in the cost of antibiotic prescription was compared between control and intervention groups.

Secondary Outcome Measures

Name	Time	Method
Long term antibiotic prescription rates	Effect of the intervention 28 to 30 months after the educational training.	Long term change in the percentage of antibiotic prescriptions between both groups
Long term antibiotic cost.	Effect of the intervention 28 to 30 months after the educational training.	Long term change in the cost of antibiotic prescriptions between both groups
Symptomatic drug prescription rates	Effect of the intervention 28 to 30 months after the educational training.	Prescription rates of symptomatic drug for respiratory infections between both groups
Symptomatic drug cost.	Effect of the intervention 28 to 30 months after the educational training.	Cost of symptomatic drug between both groups
Effect of patient age.	Effect of the intervention 28 to 30 months after the educational training.	Effect of patient age on antibiotic prescription between both groups
Effect of a seminar on problem-solving strategy on prescriptions.	Effect of the intervention 28 to 30 months after the educational training.	A second randomization was performed among the intervention group. In one subgroup, GPs attended an additional seminar on problem-solving strategies. Antibiotic prescription rates were compared between controls, evidence-based and problem-solving subgroups. Antibiotic cost was also compared between the both subgroups

Trial Locations

Locations (1)

Henri Mondor Hospital, department of general practice; 🇫🇷 Créteil, France