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Published on: August 30, 2018
Using a decision support tool to reduce inappropriate antibiotic use after a delayed prescription
Elisabeth D C Sievert1,2, Rian Gross3, Lars Korn1,2
1Health Communication, Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany.
Applied Psychology. Health and Well-Being
|August 8, 2026
Summary
Decision support tools, including leaflets and symptom monitoring, significantly reduced inappropriate antibiotic use in primary care. These interventions also decreased patient decisional conflict, promoting responsible antibiotic prescribing.
Area of Science:
- Health Psychology
- Behavioral Science
- Infectious Disease Prevention
Background:
- Antimicrobial resistance is a significant global health threat, exacerbated by antibiotic overprescribing in primary care.
- Delayed antibiotic prescribing is a strategy to mitigate overuse, but patient adherence is often suboptimal.
- Effective decision support is needed to optimize delayed prescribing and reduce unnecessary antibiotic consumption.
Purpose of the Study:
- To evaluate the effectiveness of a World Health Organization decision support leaflet, alone or combined with other interventions, in reducing inappropriate antibiotic use for viral infections.
- To assess the impact of decision support tools on patient decisional conflict and the clarity of treatment values.
- To examine how different combinations of decision support interventions influence antibiotic prescribing behavior in a simulated primary care setting.
Main Methods:
- An online experiment with 663 UK adults using a behavioral game measure with financial incentives to simulate delayed antibiotic prescriptions.
- Participants were randomized into five conditions: control, leaflet only, leaflet with value integration, leaflet with active symptom monitoring, and leaflet with both value integration and active monitoring.
- Statistical analyses were performed to compare inappropriate antibiotic use and decisional conflict across experimental conditions.
Main Results:
- All decision support conditions showed significantly lower inappropriate antibiotic use compared to the control group (p < .001).
- Decision support tools effectively reduced decisional conflict (p < .001), enhancing value clarity and perceived decisional support.
- The combination of interventions, particularly leaflet with active symptom monitoring, demonstrated strong potential in guiding appropriate antibiotic decisions.
Conclusions:
- Integrating decision support tools into delayed antibiotic prescription protocols can effectively reduce inappropriate antibiotic use for viral infections.
- These tools enhance patient understanding and confidence, thereby decreasing decisional conflict and promoting more informed antibiotic choices.
- Evidence-based decision support interventions are crucial for optimizing antibiotic stewardship in primary care settings.
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