Research Activities, March 2014
Academic detailing helps reduce antibiotic prescribing for upper respiratory infections
Patient Safety and Quality of Care
Upper respiratory tract infections, such as bronchitis, are common diagnoses in primary care practices. Current evidence suggests that antibiotics have no or limited benefit as treatments for these infections in healthy patients. Despite this evidence, clinicians still prescribe antibiotics unnecessarily at a rate of over 50 percent. A recent study found that academic detailing (physicians visiting physicians to provide intensive education on the topic) resulted in decreased antibiotic prescribing for upper respiratory infections, but provider education mailings to patients did not.
Researchers examined two interventions that targeted clinicians with high antibiotic prescribing rates. The first intervention involved physician peer visits to discuss the topic (also known as academic detailing). In the second intervention group, physicians sent their patients with an upper respiratory infection diagnosis in the past 2 years the brochure titled "Head & Chest Colds" along with an explanatory letter signed by the provider.
The academic detailing intervention resulted in a significant reduction in antibiotic prescribing, from 43 percent to 33 percent. No significant change, however, was observed with the patient mailing intervention. The researchers also found wide variation in the prevalence of antibiotic prescribing for different practices as well as different individuals within a practice. They suggest that other unmeasured provider factors may be at work in influencing providers' antibiotic prescribing habits. The study was supported in part by AHRQ (HS10399).
See "Effectiveness of interventions in reducing antibiotic use for upper respiratory infections in ambulatory care practices," by Christopher Vinnard, M.D., M.S.C.E., Darren R. Linkin, M.D., M.S.C.E., A. Russell Localio, Ph.D., and others in the February 2013 Population Health Management 16(1), pp. 22-27.