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Long-term effect of a practice-based intervention (HAPPY AUDIT) aimed at reducing antibiotic prescribing in patients with respiratory tract infections

2018; Oxford University Press; Volume: 73; Issue: 8 Linguagem: Inglês

10.1093/jac/dky137

1460-2091

Carl Llor, Lars Bjerrum, José Molero, Ana Moragas, Beatriz González López‐Valcárcel, María José Monedero, Manuel Arias, Marina Cid, Juan de Dios Alcántara, Josep M. Cots, J. M Méndez Ribas, Guillermo García, Jesús Ortega, Vicenta Pineda, Gloria Guerra, Susana Munuera, Idoioa Arrillaga Ocampo, Francisco Atienza Martín, E Amat, Marta Bernal Raya, Pablo Cabezas Saura, P. Castano, Carmen Dastís Bendala, Irene V de Tena Roger, Pedro Fernández-Nieto Fernández, Amalia Filella Sierpes, M Isabel González Rodríguez, Antonio Hernández Alonso, Guillermo Largaespada Pallaviccini, Beatriz López Fernández, Inés M López Huerta, Beatriz Luque López, Yanina Maldonado, M Luisa Manzanares Torné, Leonor Marín Pérez, Melecia Granero, Rocío Martínez Pérez, M Antonia Máximo Torres, Ainhoa Mestraitua Vázquez, Mercedes Moreno Labrado, M Luisa Moya Rodríguez, José Oropesa de Cáceres, Irene Padial Reyes, Antonio Paniagua Galisteo, Vanessa Parra García, M Encarnación Peláez Gálvez, Juan J Quero Perabá, Marta Barrachina, Miguel Sagristá González, C. Abascal, Jesús C Sánchez Vázquez, Auxiliadora Sanchís Osuna, J Cristóbal Sendín González, Rosario Serrano Ortega, Miguel Silva Cueto, Guillermo Cisneros, Ester Adelantado Pozuelo, Daniel Bestard Marín, A. Nadal, M. Ibañez, Esther Domínguez Padilla, Alberto Eek Comas, Margarita Fornés Homar, Maria E Garau Miquel, Prado García Servera, Salvador J Gestoso Gaya, María J González-Bals González, M Garcia, Antoni J Jover Palmer, Magdalena Llinàs Suau, Marian Llorente Sanmartín, Blanca Martínez Andión, Adriano Mayrata Vicens, David Medina i Bombardó, Gabriel Moragues Sbert, Joana M Oliver Gornals, Etel Oliver Roset, Jessica Simo, Juana Pérez Galmés Palmer, Susana Vives, Lourdes Quintana Torres, J. Bauzá, Francisco Gambón, Jaime Ripoll Sánchez, Miguel Román-Rodríguez, Natalia Serrano Gomila, Magdalena Servera Trias, Isabel M Socias Buades, Machado Barbosa, Joana Tortella Morro, Lucia Ugarriza Hierro, Silvia Vega García, Pilar Utrilla, M Ruano, M Isabel Cardenes Romero, Jonás de la Cruz Cabrera, Margarita García García, M Carmen Guerra, R. Koch, M Huertas Llamas Martínez, M Elena Martín Santana, Alicia Monzón Guerra, Marta Moreno Ramos, Caridad Sánchez Artiles, Lucía Tejera Pulido, José M Toscano, Carlos Villalón Prieto, A A Iván Perdomo, Francisco Castrillo Villar, Pilar Cobas Pacín, M Jesús Colas Martínez, Coral Díez Pérez, Peregrina Eiroa Patiño, Ana Fernández Álvarez, Luis Fuciños Cebreiro, J Antonio Gómez Villalobos, M Esther González García-Mayor, Ricardo M Héctor Sanz, Susana Hernáiz Valero, Esther López Carbajales, J Luis López Vilar, Elena Lorenzo Llauger, Elisa Mosquera Gayoso, Concepción Nogueiras Santas, M Pilar Pintos Martínez, M. Rey, Lucía Rodríguez Nieto, Santiago Santidrián Arias, Jesús Sueiro Justel, R. Morras, José María Casanova Colominas, Santiago Castellanos Redondo, M Teresa Cobos Hinojal, José Corral Brihuega, Marina Alonso, Belén de la Fuente Martín, Silvia de las Heras Loa, Angélica Fajardo Alcántara, M Jesús Ferrer Signes, Antonia García del Val, M Mar García Rabanal, Gema García Sacristán, Álvaro García Vega, M Elena Gerez Sánchez-Escribano, Paloma González Escobar, Rosa M González San Segundo, M Elena Hermida López, Paloma Hernández Almarza, Ana Ibarra Sánchez, Ángeles Lagos Aguilar, Ascensión Lázaro Damas, M Eugenia López Delgado, Guillermina López Fernández, Rosario López Morell, M José Lucena Martín, Jaime Marín Cañada, Rosa Martín de Cabo, Blanca Matilla-Pardo, Teresa Mazarro Enrique, Cristina Moral Moraleda, Adela Moreno Mateos, Joaquín Morera Montes, Renata Muñoz Bieber, Javier Muñoz Gutiérrez, Alicia Muñoz Núñez, M Arantzazu Murciano Antón, Patricia Navarro Gil, Lourdes Pulido Izquierdo, Carmen Rodríguez Fernández, Ana Rodríguez Nebreda, Mauro Quiroga, M Asunción Rosado López, A. Molina, Rocío Susana Ruíz Vargas, Irmina Saldaña Alonso, Mar Sánchez Martín, Laura Santos Larregola, Juana M Torres Martínez, Gema Val Morales, Amalia Velázquez García, Lourdes Visedo Campillo, Antonio Yagüe Hernando, Ascensión Aicua Sadia, Manolo Sánchez, Carmen Babace Isturiz, Diego Beni Ruiz, Nieves Calavia Rueda, M Mar Díez Casado, Melissa Valderrama, Francisco García Marín, Tomás García Martínez, Ana M Gómez Ruiz, Elvira Moreno Hernández, Sandra Fernández Rodríguez, M José Palomo Larrieta, Olga Revilla González, R Fuente, José Luis Torres Baile, Antonio Trueba Castillo, Ana M Vázquez Medrano, Carmen Alonso Alonso, Fernando Álvarez Guisasola, Pablo Belderraín Belderraín, J Carlos Bango Melcón, Teresa Díaz Mujica, Deopatria Azucena Esteban Fresno, Rocío Fernández Collar, Leonor Fuentes Martin, Alfonso García Viejo, Ramón Macía Pérez, Carmen Martín López, Ernesto Martínez Estrada, Herminia Menéndez Fernández, Covadonga Monte Llavona, M Amor Paredes González, Cristina Pérez Canal, Javier Pérez Fernández, M Mar Pizarro López, Rosa Rodríguez, J Ignacio Rodríguez-Arias Palomo, Alicia Rodríguez, Felipe J Rodríguez Gordaliza, Celia T Tamargo García, Salvador Tranche Iparraguirre, Marja Aira, R Villa Estébanez, Juan Alamar Provecho, M Teresa Amorós Barber, Miguel Antón Sánchez, Manuel Batalla Sales, Lourdes Bermejo Mora, Núria Bosch Girona, M Pilar Carceller Sales, Rosa Carrión Villanueva, Teresa Raga, M. Orduña, Concepción García Domingo, Carmen Hernández Espinosa, Blanca Folch Marín, Carmen Gandía Moya, Amparo Haya Guaita, Eva M Izquierdo Hidalgo, Engracia López González, Nuria Mallén Navarro, Pilar Marín Lluch, Amparo Meneu Ferrer, Helena Molina Raga, Adela Moreno Fernández, Ángeles Pérez Campos, Belén Persiva Saura, Gloria Rabanaque Mallén, Remei Raga Marí, Jazmín Ripoll Perelló, Pilar Roca Navarro, M Luisa Tregón Moliner,

Pneumonia and Respiratory Infections

Few studies have evaluated the long-term effects of educational interventions on antibiotic prescription and the results are controversial. This study was aimed at assessing the effect of a multifaceted practice-based intervention carried out 6 years earlier on current antibiotic prescription for respiratory tract infections (RTIs).The 210 general practitioners (GPs) who completed the first two registrations in 2008 and 2009 were invited to participate in a third registration. The intervention held before the second registration consisted of discussion about the first registration of results, appropriate use of antibiotics for RTIs, patient brochures, a workshop and the provision of rapid tests. As in the previous registrations, GPs were instructed to complete a template for all the patients with RTIs during 15 working days in 2015. A new group of GPs from the same areas was also invited to participate and acted as controls. A multilevel logistic regression analysis was performed considering the prescription of antibiotics as the dependent variable.A total of 121 GPs included in the 2009 intervention (57.6%) and 117 control GPs registered 22 247 RTIs. On adjustment for covariables, compared with the antibiotic prescription observed just after the intervention, GPs assigned to intervention prescribed slightly more antibiotics 6 years later albeit without statistically significant differences (OR 1.08, 95% CI 0.89-1.31, P = 0.46), while GPs in the control group prescribed significantly more antibiotics (OR 2.74, 95% CI 2.09-3.59, P < 0.001).This study shows that a single multifaceted intervention continues to reduce antibiotic prescribing 6 years later.