uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Reducing the prescribing of antibiotics in general practices through outreach visits.: A randomised controlled trial in southern Denmark
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. (Allmänmedicin)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. (Allmänmedicin)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. (Allmänmedicin)
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Aims: To study the effects of outreach visits and a simple desk guide on the prescribing in general practice of all antibacterial agents intended for systemic use (ATC code J01), broad spectrum penicillins (J01CA), pivmecillinam (J01CA08), and macrolids (J01FA), and betalaktamase sensitive penicillin (J01CE) to expected to be unchanged or increase.

Study population: Eighty-eight out of 94 general practices in the former Storstrøm County, that agreed to participate, were randomly allocated into two parallel study arms, an intervention and a control area.

Method: The year 1999 was used as the run-in-period, 2000 as the intervention period, and the spring of 2001 as the post-trial period. All participating practices received an outreach visit during the intervention period, and focus in the intervention area was on the prescribing of antibacterial agents. Data on practice characteristics and on prescribing level for the six drug groups was obtained from the County Health Insurance database. Multiple linear regression analysis was used to evaluate differences in prescribing trends across the study period.

Results: After adjustments for differences in initial prescribing levels practices in the intervention area prescribed less of all antibacterial agents intended for systemic use and less broad spectrum penicillin than practices in the control area. For the other drug groups under study, pivmecillinam, betalaktamase sensitive penicillins and macrolids, there were non-significant trends in the intended direction.

Conclusions: Outreach visits and a simple desk guide appear to affect the prescribing of antibacterial agents as intended.

Keyword [en]
outreach visits, prescribing, antibiotics, general practice, RTC
National Category
Medical and Health Sciences
Research subject
Family Medicine
Identifiers
URN: urn:nbn:se:uu:diva-192311OAI: oai:DiVA.org:uu-192311DiVA: diva2:589375
Note

Submitted

Available from: 2013-01-17 Created: 2013-01-17 Last updated: 2013-02-14
In thesis
1. Promoting Rational Drug Prescribing in General Practice
Open this publication in new window or tab >>Promoting Rational Drug Prescribing in General Practice
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aims: To introduce the concepts “quality assurance”, “rational drug prescribing” and “outreach visits” in general practice in Storstrøm County, Denmark and study the effect of unsolicited mailed feedback and outreach visits on drug prescribing.

Methods: The first step was to generate standardised charts displaying the county variations of drug volume prescribing within 13 major drug groups at the second ATC-level. The charts were mailed unsolicited to the 94 general practices in the county. Each practice could identify its position within the county prescribing variation. This procedure was repeated every six months from 1992 to 1998. In 1998 annual outreach visit were offered to general practice and 88 of 94 practices accepted. The awareness of prescribing profiles was monitored during the visits in 1998 and 1999. In 2000 a randomised controlled trial allocating practices into two parallel arms was launched. Effects of two desk guides on rational drug prescribing promoted during outreach visits were evaluated.

Results: During the period of mailed feedback, there was a large variation in drug prescribing volumes between practices but little within-practice variation over time. No significant change was detected. Practitioners’ assessment of their own prescribing profiles improved significantly through the outreach visits. The prescribing of antibiotics was significantly affected by the desk guide whereas no effect was detected on the prescribing of non-steroid anti-inflammatory drugs.

Conclusions: Semi-annually mailed feedback over a seven-year period had no significant effect on prescribing volumes or variations in prescribing volumes, but some effect on the practitioners’ awareness of their own prescribing profiles. Outreach visits significantly improved the awareness. A randomised controlled trial using outreach visits combined with a simple desk guide affected the prescribing of some antibacterial drugs as intended whereas the similar intervention had no detectable effect on the prescribing of non-steroid anti-inflammatory drugs.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 64 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 858
Keyword
rational drug prescribing, family medicine, general practice, postal feedback, outreach visits, randomised controlled trial
National Category
Clinical Medicine
Research subject
Family Medicine
Identifiers
urn:nbn:se:uu:diva-192315 (URN)978-91-554-8582-5 (ISBN)
Public defence
2013-03-01, Rudbeckssalen, Dag Hammarskjölds väg 20, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2013-02-07 Created: 2013-01-17 Last updated: 2013-02-14Bibliographically approved

Open Access in DiVA

No full text

Authority records BETA

Vægter, KeldSvärdsudd, Kurt

Search in DiVA

By author/editor
Vægter, KeldSvärdsudd, Kurt
By organisation
Department of Public Health and Caring Sciences
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

urn-nbn

Altmetric score

urn-nbn
Total: 628 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf