Episode 309: 308. Mailed feedback to Primary Care Physicians on Antibiotic Prescribing

Episode 309: 308. Mailed feedback to Primary Care Physicians on Antibiotic Prescribing

https://www.bmj.com/content/385/bmj-2024-079329



Overprescription of antibiotics by primary care clinicians is a major modifiable driver of antibiotic resistance. Evidence suggests that peer-comparison feedback can reduce antibiotic overprescription, but the optimal content and delivery of such feedback is unclear

Researchers randomized 5000 family physicians in Ontario, Canada, to receive either mailed feedback (with data on individual prescribing rates compared with peers' prescribing rates, plus educational information on optimal prescribing) or no mailed feedback (control group).

Clinicians in the intervention group were randomized further to (a) receiving personalized prescribing data that were adjusted, versus not adjusted, for case mix, and (b) receiving information on potential harms of antibiotics, versus not receiving such information.


Compared with controls, the intervention group had significantly lower mean rates of overall antibiotic prescribing (59 vs. 56 prescriptions per 1000 patient visits; relative rate, 0.95), apparently unnecessary antibiotic prescriptions (e.g., for viral illnesses; RR, 0.89), long-duration antibiotic prescriptions (RR, 0.85), and broad-spectrum antibiotic prescriptions (RR, 0.94) in the first 6 months after the mailings.

Only 18% of a sample of intervention physicians confirmed receipt of feedback letters.

Tells me—there has to be a personal connection. If you think this is you then you are likely to be make a change but with only 18% people confirming receipt is tells me

Physicians are burnt out—I refuse to believe they don’t care but rather they are drowning





Jaksot(385)

Episode 391: 402. Functional disability after clinically significant extracranial bleeding: a secondary analysis of ASPREE

Episode 391: 402. Functional disability after clinically significant extracranial bleeding: a secondary analysis of ASPREE

https://www.jthjournal.org/article/S1538-7836(25)00109-6/fulltextAntithrombotic agents, like aspirin and anticoagulants, are essential for treating many cardiovascular conditions. However, a common si...

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Episode 390: 401. Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension

Episode 390: 401. Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension

https://jamanetwork.com/journals/jama/article-abstract/2834632SummaryThe article examines the effectiveness and safety of zilebesiran, an RNA interference therapeutic agent, when used in combination w...

4 Kesä 20258min

Episode 389: 400. CRP, Lipoprotein A, LDL for cardiac risk assessment

Episode 389: 400. CRP, Lipoprotein A, LDL for cardiac risk assessment

https://www.nejm.org/doi/full/10.1056/NEJMoa2405182?query=recirc_Semantic  Key Takeaways Extended Predictive Value of Biomarkers: High-sensitivity C-reactive protein (CRP), LDL cholesterol, and lipop...

29 Touko 20259min

Episode 388: 399. Use of albumin-adjusted calcium measurements in clinical practice

Episode 388: 399. Use of albumin-adjusted calcium measurements in clinical practice

Desgagnés N et al. Use of albumin-adjusted calcium measurements in clinical practice. JAMA Netw Open 2025 Jan 21; 8:e2455251. (https://doi.org/10.1001/jamanetworkopen.2024.55251)Overall, total calcium...

27 Touko 20257min

Episode 387: 398. Which is Better, Tirzepatide or Semaglutide?

Episode 387: 398. Which is Better, Tirzepatide or Semaglutide?

https://www.nejm.org/doi/10.1056/NEJMoa2416394At 72 weeks, the mean percentage decrease in weight was significantly greater with tirzepatide than with semaglutide (20% vs. 14%). Gastrointestinal side ...

21 Touko 20258min

Episode 386: 397. What is the new drug for smoking cessation?

Episode 386: 397. What is the new drug for smoking cessation?

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2832701In this multisite trial, 800 adults who smoked 10 or more cigarettes daily (mean duration of smoking, ≈35 years) were randomize...

9 Touko 20255min

Episode 385: 396. Vitamin D and Kids (CME)

Episode 385: 396. Vitamin D and Kids (CME)

What does the evidence and the guidelines say about the use and testing of Vitamin D in kids

7 Touko 20258min

Episode 384: 395. How accurate is the BMI?

Episode 384: 395. How accurate is the BMI?

Aryee EK et al. Prevalence of obesity with and without confirmation of excess adiposity among US adults. JAMA 2025 Apr 17; [e-pub]. (https://doi.org/10.1001/jama.2025.2704)The rate of obesity was 39.7...

6 Touko 20255min

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