Reducing Outpatient Antibiotic Prescribing for Acute Respiratory Infections: A Quasi-Experimental Study
1School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, Missouri cbrownfnp@gmail.com.
Problem:
Approximately 50% of antibiotics prescribed are not necessary; nevertheless, in the United States among the many outpatient prescriptions, there are few more widely prescribed than antibiotics. The overuse of antibiotics to treat viral infections has been largely responsible for the emergence of antibiotic resistance.
Methods:
A quasi-experimental study was conducted among a sample of eight urgent care providers who received the 1-hour Reducing Outpatient Antibiotic Resistance (ROAR) educational intervention on antibiotic overuse and appropriate prescribing. Outcomes measured included provider antibiotic prescribing rates for viral illnesses before and after intervention, prescribing practices among the providers, and provider awareness and beliefs regarding antibiotic prescribing and resistance.
Results:
The antibiotic prescribing rate decreased from 30% to 20% after intervention, p = .078. Pre-intervention patients had a 3.3 times (p = .001) and post-intervention patients had a 4.2 times (p ≤ .0005) greater likelihood of being prescribed an antibiotic if they were seen by a physician than if they were seen by a nurse practitioner. Within their setting, 87% believed antibiotics are overused, and 99% believed antibiotic resistance is a problem.
Discussion:
Additional research utilizing the ROAR intervention is necessary to evaluate its effect on antibiotic prescribing in the urgent care setting.
Insights
The Reducing Outpatient Antibiotic Resistance (ROAR) educational intervention reduced antibiotic prescribing for viral infections in urgent care settings. Further research is needed to confirm its effectiveness.
Area of Science:
- Infectious Diseases
- Public Health
- Pharmacology
Background:
- Antibiotic overuse, particularly for viral infections, contributes significantly to antibiotic resistance.
- Urgent care settings are a major source of outpatient antibiotic prescriptions in the United States.
Purpose of the Study:
- To evaluate the impact of the Reducing Outpatient Antibiotic Resistance (ROAR) educational intervention on antibiotic prescribing practices in urgent care.
- To assess changes in provider prescribing rates, practices, and awareness of antibiotic resistance.
Main Methods:
- A quasi-experimental study involving eight urgent care providers.
- Implementation of a 1-hour ROAR educational intervention focusing on antibiotic overuse and appropriate prescribing.
- Measurement of antibiotic prescribing rates for viral illnesses before and after the intervention.
Main Results:
- Antibiotic prescribing rates decreased from 30% to 20% post-intervention (p = .078).
- Physicians were more likely to prescribe antibiotics than nurse practitioners both pre- and post-intervention.
- High provider belief in antibiotic overuse (87%) and the severity of antibiotic resistance (99%) was observed.
Conclusions:
- The ROAR intervention shows potential for reducing antibiotic prescribing in urgent care.
- Further investigation is warranted to validate the ROAR intervention's efficacy in the urgent care environment.
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