Table 1.
Randomized Controlled Trials Demonstrating Decreased Antibiotic Prescription Rates in Response to Patient- or Public- Centered Educational Interventions
| Location of Intervention (years observed) | Setting | Patient Education | Provider Education | Outcome Measure | Prescription Rate Change | |||
|---|---|---|---|---|---|---|---|---|
| Control | (Full) Intervention | Intervention Effect | P value (intervention effect compared to control) | |||||
| Utah, Idaho (2001–2005) [45] | Rural Communities | Educational messages in examination rooms, pharmacies, newspapers, mailings. Key messages included “Do not treat viral infections with antibiotics”, how to manage respiratory tract infections, and ways to improve communication with the doctor | Computer decision support for treatment recommendations | Total Prescriptions /100 person-years | 2.6 (95%CI[−3.7,9.4]) | −8.8 (95% CI[−13.2,-4.2]) | Not reported | Not reported |
| Massachusetts, Northwest Washington State (1996–1998) [27] | Managed Care Organization (MCO) Practices | CDC brochure mailings, waiting room materials | Meetings, CDC recommendations, feedback of prescribing rates | Children 3 to < 36 mo. old (antibiotics/person-year) | −11.5% (P < .0001) | −18.6% (P < .0001) | −16% (95%CI[− 8,-23%])a | < 0.01 |
| Children 36 to < 72 mo. old (antibiotics/person-year) | −9.7% (P < .0001) | −15% (P < .0001) | −12% (95%CI[− 2,-21%])a | < 0.01 | ||||
| Massachusetts (2000–2003) [28] | Community-wide | Materials consistent with CDC principles regarding antibiotic indications and resistance were distributed to offices, pharmacies, child care, and by mail | Kickoff dinners and educational materials, feedback about prescribing practices | Children 24 to < 48 months (antibiotics/person-year) | − 10.30% | −14.50% | −4.20% | < 0.01 |
| Children 48 to < 78 months (antibiotics/person-year) | −2.50% | −9.30% | −6.70% | < 0.0001 | ||||
| US Regions (2003–2005) [42] | Veterans Administration (VA) and non-VA emergency departments | CDC waiting room posters and brochures, interactive computer kiosk for information about viral infections | Educational sessions on judicious use, emphasizing CDC principles. Site-specific performance feedback | Antibiotics for Respiratory Tract Infections and Acute Bronchitis | 0.5% (95%CI[− 3,5%]) | −10% (95%CI[− 18,-2%]) | Not reported | Not reported |
a Adjusted for baseline prescribing rates and other cofounders [27]