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 367: 378. What is the Best Way To Treat Ductal Carcinoma In Situ

Episode 367: 378. What is the Best Way To Treat Ductal Carcinoma In Situ

https://jamanetwork.com/journals/jama/article-abstract/2828218DCIS is a non-invasive form of breast cancer, meaning the abnormal cells are contained within the milk ducts. For years, the standard trea...

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Episode 366: 377. Does How Long You Have Hypertension Matter?

Episode 366: 377. Does How Long You Have Hypertension Matter?

Association of Duration of Recognized Hypertension and Stroke Risk: The REGARDS Study   (Transition Music - Short and subtle - 2 seconds)Host:  Hypertension is a well-known risk factor for stroke, but...

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Episode 365: 366. Association of dose of inhaled corticosteroids and frequency of adverse events

Episode 365: 366. Association of dose of inhaled corticosteroids and frequency of adverse events

Bloom CI et al. Association of dose of inhaled corticosteroids and frequency of adverse events. Am J Respir Crit Care Med 2025 Jan; 211:54. (https://doi.org/10.1164/rccm.202402-0368OC)  Bloom and coll...

7 Helmi 20256min

Episode 364: 364. The safety and efficacy of sodium–glucose cotransporter 2 inhibitor in hospitalized patients

Episode 364: 364. The safety and efficacy of sodium–glucose cotransporter 2 inhibitor in hospitalized patients

Gao FM et al. A systematic review and meta-analysis on the safety and efficacy of sodium–glucose cotransporter 2 inhibitor use in hospitalized patients. Diabetes Care 2024 Dec 1; 47:2275. (https://doi...

4 Helmi 20257min

Episode 363: 262. Myocardial injury in patients with hip fracture

Episode 363: 262. Myocardial injury in patients with hip fracture

Is accelerated surgery for hip fracture better for high-risk patients? A recent substudy of the HIP ATTACK trial has shed new light on this topic. The original trial, published in 2020, compared accel...

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Episode 362: 261. What to do with the beta blocker following a Myocardial Infarction

Episode 362: 261. What to do with the beta blocker following a Myocardial Infarction

Today, we're discussing two groundbreaking studies from 2024 that challenge our understanding of β-blocker therapy for secondary prevention after myocardial infarction, or MI.Let's start with a Swedis...

15 Tammi 20256min

Episode 361: 260. METHODS MONDAY-- EVENT RATE

Episode 361: 260. METHODS MONDAY-- EVENT RATE

Methods Monday  --- Accuracy of Event Rate and Effect Size Estimation in Major Cardiovascular Trials: A Systematic Review | Cardiology | JAMA Network Open | JAMA Network  During the design of a random...

13 Tammi 202510min

Episode 360: 259. Urinary Retention Evaluation and Catheterization Algorithm for Adult Inpatients

Episode 360: 259. Urinary Retention Evaluation and Catheterization Algorithm for Adult Inpatients

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10 Tammi 20257min

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