Improving antibiotic prescribing in office practice. A controlled trial of three educational methods.
Improving antibiotic prescribing in office practice. A controlled trial of three educational methods.
复制标题
改善办公室实践中的抗生素处方。
DOI：
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发表时间：
1983
期刊：
影响因子：
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通讯作者：
W. Miller
中科院分区：
文献类型：
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作者：
W. Schaffner;W. Ray;C. Federspiel;W. Miller
我们进行了一项全州范围的对照试验，采用三种方法来改善办公室实践中的抗生素处方：邮寄小册子，药物教育者访问和医生访问。教育主题是三种抗生素禁忌办公室的做法和口服头孢菌素。医疗补助处方数据用于选择需要教育的捐赠者。通过比较接受教育的医生与选择作为对照的可比医生的处方变化（干预前一年与干预后一年）来评估方法的效果。邮寄的小册子没有明显的效果，药物教育者也只有适度的效果。医生访问产生了强烈的归因于减少处方的两种药物类别。对于禁忌抗生素，医生处方数量减少了18%，每位医生接受这些药物的患者数量减少了44%，每位医生开具的处方数量减少了54%。对于口服头孢菌素类药物，患者数量和每位医生的处方数量均减少了21%。医生们对旨在提高护理质量和降低护理成本的建议反应同样良好。
We conducted a statewide controlled trial of three methods to improve antibiotic prescribing in office practice: a mailed brochure, a drug educator visit, and a physician visit. Educational topics were three antibiotics contraindicated for office practice and oral cephalosporins. Medicaid prescribing data were used to select donors who needed education. The effect of the methods was evaluated by comparing the change in prescribing (the year before the intervention v the year after the intervention) for the doctors receiving education with the prescribing of comparable doctors chosen as controls. The mailed brochure had no detectable effect, and the drug educator had only a modest effect. The physician visits produced strong attributable reductions in prescribing of both drug classes. For the contraindicated antibiotics, the reductions were 18% in number of doctors prescribing, 44% in number of patients per doctor receiving these drugs, and 54% in number of prescriptions written per doctor. For the oral cephalosporins, both number of patients and number of prescriptions per doctor were reduced by 21%. Doctors responded equally well to recommendations designed to improve the quality of care and to reduce the cost of care.