Shared decision-making between doctors and patients can reduce antibiotic use

A training tool that helps physicians involve patients in decision-making can reduce the use of antibiotics for acute respiratory infections, according to a study published in CMAJ (Canadian Medical Association Journal).

Antibiotics are prescribed too often for acute respiratory infections, even though many are not bacterial infections and therefore will not respond to antibiotic use. is a health concern and may be contributing to .

Researchers conducted a cluster randomized trial to determine the impact of a shared decision-making training program called DECISION+2 on the . Shared decision-making, in which a health care professional and patient make a decision together based on evidence and patient preferences, has been shown to be effective when benefits of treatment are not clearly evident for all patients.

The study was divided into two groups, one group of 181 patients who consulted 77 physicians in 5 family practice teaching units using DECISION+2 and a control group of 178 patients who consulted 72 physicians in 4 family practice teaching units. DECISION+2 included an online tutorial followed by an interactive workshop.

"After the intervention, patients in the DECISION+2 group were significantly less likely than patients in the control group to report a decision to use antibiotics immediately after consultation," writes Dr. France Légaré, Research Centre of Centre Hospitalier Universitaire de Québec and Department of Family Medicine and Emergency Medicine, Universitaire Laval, Québec, with coauthors. "The reduction in decisions to use antibiotics was observed in all intervention teaching units, while an increase was seen in 3 of 4 teaching units in the control group."

The results of this study are similar to those from an earlier pilot study that looked at the feasibility of this larger trial.

"These studies indicate that a combination of live and media education are generally effective in changing physician performance in the context of for ," write the authors. "These findings are important given the debate and widespread skepticism about the effect of medical education on the performance of physicians in the practice setting."

More information: Study online: www.cmaj.ca/lookup/doi/10.1503/cmaj.120568

add to favorites email to friend print save as pdf

Related Stories

Study hints at antibiotic overuse in home-care patients

Jun 15, 2011

A study of Canadian home-care patients suggests doctors may be overprescribing antibiotics for patients receiving ongoing medical care at home. The study, published in the June issue of Infection Control and Hospital Epidemiology, the jo ...

Treating acute coughs

Mar 24, 2011

(PhysOrg.com) -- Prescribing antibiotics for patients with discoloured phlegm caused by acute cough has little or no effect on alleviating symptoms and recovery, a new University study has found.

Antibiotics often the wrong prescription for pediatric asthma

Jun 01, 2011

(Medical Xpress) -- At nearly one in six pediatric asthma visits, antibiotics are prescribed as a remedy, despite national guidelines against the practice. Ian Paul, departments of pediatrics and public health sciences, Penn ...

Recommended for you

Study recalculates costs of combination vaccines

Apr 17, 2014

One of the most popular vaccine brands for children may not be the most cost-effective choice. And doctors may be overlooking some cost factors when choosing vaccines, driving the market toward what is actually a more expensive ...

Drug watchdog urges vigilance in cancer drug theft

Apr 17, 2014

Europe's medicine watchdog urged doctors Thursday to be vigilant in administering the cancer drug Herceptin, vials of which had been stolen in Italy and tampered with before being sold back into the supply chain.

User comments