Personalized Prescription Feedback Using Routinely Collected Data to Reduce Antibiotic Use in Primary Care: A Randomized Clinical Trial.

摘要: Importance Feedback interventions using routinely collected health data might reduce antibiotic use nationwide without requiring the substantial resources and structural efforts of other stewardship programs. Objective To determine if quarterly prescription feedback over 2 years reduces when implemented in a complex care system. Design, Setting, Participants Pragmatic randomized trial claims on 2900 primary physicians with highest rates Switzerland. Interventions Physicians were to updated personalized (n = 1450) or usual (n = 1450). was provided both by mail online from October 2013 2015 supported an initial 1-time provision evidence-based guidelines. Main Outcomes Measures The outcome prescribed defined daily doses (DDD) any patient per 100 consultations first year analyzed intention-to-treat. We further prescriptions specific antibiotics, age groups, sex for second investigate persistency effects time. Results had 10 660 124 follow-up, 1 175 780 packages antibiotics 10 290 182 DDD. receiving same amount all patients (between-group difference, 0.81%; 95% CI, −2.56% 4.30%; P  = .64) −1.73%; −5.07% 1.72%;  = .32) compared control group. Prescribing children aged 6 18 −8.61% lower than group (95% −14.87% −1.90%;  = .01). This difference diminished −4.10%; −10.78% 3.07%;  = .25). fewer adults 19 65 −4.59%; −7.91% −1.16%; Conclusions Relevance program routine prescribing not associated change use. In older children, adolescents, younger less prescribed, but consistently entire intervention period. Trial Registration clinicaltrials.gov Identifier:NCT01773824