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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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 significantly reduced inappropriate antibiotic use in primary care. These tools, integrated with delayed prescriptions, empower patients to make more informed decisions about antibiotic use for viral infections.
Area of Science:
- Health Behavior
- Infectious Disease Epidemiology
- Clinical Decision Making
Background:
- Antimicrobial resistance (AMR) is a significant global health threat, exacerbated by antibiotic overprescribing in primary care.
- Delayed antibiotic prescriptions are a strategy to mitigate overuse, but patient adherence can be challenging.
- Inappropriate antibiotic use for viral infections remains a key driver of AMR.
Purpose of the Study:
- To evaluate the effectiveness of a World Health Organization (WHO) decision support leaflet, alone or combined with other interventions, in reducing inappropriate antibiotic use.
- To assess the impact of decision support tools on patient decisional conflict regarding antibiotic prescriptions.
- To examine the role of behavioral interventions in promoting responsible antibiotic stewardship.
Main Methods:
- An online experiment with 663 UK adults using a behavioral game measure with financial incentives to model delayed prescriptions.
- Random assignment to five conditions: control, leaflet only, leaflet with value integration, leaflet with active symptom monitoring, and leaflet with both value integration and active monitoring.
- Statistical analysis 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.
- Combined interventions, particularly leaflet with value integration and active monitoring, demonstrated strong efficacy.
Conclusions:
- Integrating decision support tools into delayed prescription protocols can significantly reduce inappropriate antibiotic consumption.
- These tools enhance patient understanding and confidence, leading to more informed choices about antibiotic use.
- Behavioral interventions and decision support are crucial for effective antibiotic stewardship in primary care settings.
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