PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Health care savings: Reducing inappropriate antibiotic prescriptions

Signed commitment letter in exam rooms lowered inappropriate antibiotic prescriptions for cold symptoms by nearly 20 percent, saving $70 million/year in drug costs alone

2014-01-28
(Press-News.org) Contact information: Suzanne Wu
suzanne.wu@usc.edu
213-740-0252
University of Southern California
Health care savings: Reducing inappropriate antibiotic prescriptions Signed commitment letter in exam rooms lowered inappropriate antibiotic prescriptions for cold symptoms by nearly 20 percent, saving $70 million/year in drug costs alone Inappropriate antibiotic prescriptions are a major public health concern, costing millions of dollars in unnecessary health care costs annually and contributing to the problem of antibiotic-resistant bacteria. Still, despite widely accepted prescription guidelines, physicians continue to prescribe antibiotics for colds even when they won't help. A new study in JAMA Internal Medicine to be released January 27 offers an inexpensive and seemingly simple "nudge" that reduced inappropriate antibiotic prescribing by nearly 20 percent.

In the United States, nearly half the antibiotic prescriptions given for respiratory infections are inappropriate: for illnesses caused by viruses rather than bacteria, antibiotics won't help the patient get better. The study is part of a critical national conversation led by researchers at the USC Schaeffer Center for Health Policy and Economics to find evidence-based interventions that lower health care costs and unnecessary use of health care.

"Most quality improvement efforts have used audits or pay-for-performance incentives to try to change what providers do, but they ignore social influences that affect all people, including physicians," said senior author Jason Doctor of the USC Schaeffer Center for Health Policy and Economics, and associate professor of clinical pharmacy and pharmaceutical economics and policy at the USC School of Pharmacy. "Our study is the first to apply the principles of commitment and consistency to prescribing behavior and finds a simple, low-cost intervention that shows great promise in reducing inappropriate antibiotic prescription."

Lead author Daniella Meeker of RAND Corporation and Merkin Fellow at the USC Schaeffer Center for Health Policy and Economics; Jeffrey A. Linder, an expert in antibiotic prescribing at Brigham and Women's Hospital and Harvard Medical School; Doctor and the other authors, estimate that their simple intervention — a prominently displayed commitment letter — could eliminate 2.6 million unnecessary antibiotic prescriptions and save $70.4 million in drug costs alone if extrapolated across the United States.

The study

To test the impact of public commitment on health behavior, the researchers had physicians post a large letter about inappropriate antibiotic prescription in their exam rooms. The letter, displayed in both English and Spanish in Los Angeles clinics, had a picture of the physician and his/her signature, and explained the physician's commitment to reducing inappropriate prescriptions for acute respiratory infections, such as the common cold.

The researchers then looked at clinic records over the next three months, comparing rates of inappropriate antibiotic prescriptions to a control group that did not sign or post a public commitment poster.

The results

A signed commitment poster dramatically decreased unnecessary antibiotic prescriptions: among physicians who posted the letter, inappropriate antibiotic prescriptions fell nearly 10 percentage points, to 33.7 percent of total antibiotic prescriptions from 42.8 percent in the year before the study.

In contrast, inappropriate antibiotic prescriptions actually increased in the control group, who started with a similar 43.5 percent inappropriate prescription rate. Over the study period, the prescription of antibiotics in instances where they would not be effective rose to 52.7 percent among those who did not post a commitment poster.

Importantly, rates of appropriate antibiotic prescription did not change, the researchers found. There also was no evidence of changes to how illnesses or diagnoses were coded by clinicians.

"The findings from the study support the idea that clinicians are influenced by professional and social factors in patient care, and unlike some quality improvement interventions based upon financial incentives, we found no evidence that improvements were driven by changing documentation practices. This low-cost and easily scalable intervention has great potential to reduce inappropriate antibiotic prescribing," Meeker said.

"This intervention is a unique addition to interventions that have decreased inappropriate antibiotic prescribing for respiratory infections. Most other interventions have been focused on reminders or education and this is a novel, low-cost approach," Linder said.

The study did not look at why physicians might be inclined to overprescribe antibiotics, but possible explanations from other research include patient demand and "defensive" prescribing.

"The results move beyond educational posters, showing how public commitments and active engagement can prompt greater personal motivation to perform a behavior, in this case reversing a tendency to prescribe antibiotics when they are not effective," Doctor said.

INFORMATION:

Tara Knight of the USC School of Pharmacy; Mark Friedberg, Noah Goldstein and Craig Fox of UCLA; Alan Rothfeld of COPE Health Solutions and Guillermo Diaz of Queenscare Family Clinics, were co-authors of the study.

The research was supported by a grant from the National Institute on Aging of the National Institutes of Health to Jason Doctor (grant #: RC4 AG039115).

For more information or to request an interview with Professor Jason Doctor, contact Kukla Vera at kvera@pharmacy.usc.edu.

END



ELSE PRESS RELEASES FROM THIS DATE:

Environmental risk factor for Alzheimer's: DDT exposure

2014-01-28
Patients with Alzheimer's disease have significantly higher levels of DDE, the long-lasting metabolite of the pesticide DDT, in their blood than healthy people, a ...

New method rescues DNA from contaminated Neandertal bones

2014-01-28
Retrieval of ancient DNA molecules is usually performed with special precautions to prevent DNA from researchers or the environment to get mixed in with the DNA from the fossil. However, many ancient ...

Temple researchers shed new light on double-lung transplants

2014-01-28
In the largest retrospective study to date ...

Bye-bye 'Bytesize,' 'Reactions' debuts with Chemistry Lifehacks video

2014-01-28
WASHINGTON, Jan. 27, 2014 — After several years and millions of views, the American Chemical Society (ACS), the world's largest scientific society, is bidding farewell to its popular ...

New, unusually large virus kills anthrax agent

2014-01-28
From a zebra carcass on the plains of Namibia in Southern Africa, an international team of researchers has discovered a new, unusually large virus (or bacteriophage) that infects the bacterium that causes anthrax. ...

Scientists find genetic mechanism linking aging to specific diets

2014-01-28
Your best friend swears by the Paleo ...

Facelift complications eased with help of new 3-D imaging technique

2014-01-28
Millions of people each year remove wrinkles, soften creases and plump up their lips by injecting a gel-like material into their facial tissue. These cosmetic procedures are sometimes called "liquid ...

Choosing Wisely -- the politics and economics of labeling low-value services

2014-01-28
LEBANON, NH (JAN. 27, 1014) – The Choosing Wisely campaign, lists of services developed by physicians' specialty societies, is a good start ...

Permanent changes in brain genes may not be so permanent after all

2014-01-28
In normal development, all cells turn off genes they don't need, often by attaching a chemical methyl group to the DNA, a process called methylation. Historically, scientists believed methyl groups ...

Low vitamin D levels during pregnancy may increase risk of severe preeclampsia

2014-01-28
Women who are deficient in vitamin D in the first 26 weeks of their pregnancy may be at risk of developing severe preeclampsia, a potentially life-threatening ...

LAST 30 PRESS RELEASES:

Multi-energy X-ray curved surface imaging-with multi-layer in-situ grown scintillators

Metasurface enables compact and high-sensitivity atomic magnetometer

PFAS presence confirmed in the blood of children in Gipuzkoa

Why do people believe lies?

SwRI installs private 5G network for research, development, testing and evaluation

A new perspective in bone metabolism: Targeting the lysosome–iron–mitochondria axis for osteoclast regulation

Few military spouses use formal support services during, after deployment

Breakthrough in the hunt for light dark matter: QROCODILE project reveals world-leading constraints

2D x-ray imaging technique reveals hidden processes in CO2 electrolyzers

Rational high entropy doping strategy via modular in-situ/post solvothermal doping integration for microwave absorption

Circular Economy has been officially included in the ESCI

Recent advances in exciton-polariton in perovskite

Efficacy and safety of GLP-1 RAs in children and adolescents with obesity or type 2 diabetes

Over-the-counter sales of overdose reversal drug naloxone decline after initial surge

Global trends and disparities in social isolation

Country of birth, race, ethnicity, and prenatal depression

Kissick Family Foundation, Milken Institute announce $2 million in funding for frontotemporal dementia research and new call for proposals

Mayo Clinic study reveals hidden causes of heart attacks in younger adults, especially women

Target: BP initiative helps more than 10M adults with hypertension

New initiative launched to improve care for people with certain types of heart failure

You’ve never seen corn like this before

Mediterranean diet could reduce gum disease

Mount Sinai launches cardiac catheterization artificial intelligence research lab

Why AI is never going to run the world

Stress in the strands: Hair offers clues to children’s mental health

UCLA distinguished professor, CVD researcher to receive 2025 Basic Research Prize

UT San Antonio School of Public Health: The People’s School

‘Preventable deaths will continue’ without action to make NHS more accessible for autistic people, say experts

Scientists shoot lasers into brain cells to uncover how illusions work

Your ecosystem engineer was a dinosaur

[Press-News.org] Health care savings: Reducing inappropriate antibiotic prescriptions
Signed commitment letter in exam rooms lowered inappropriate antibiotic prescriptions for cold symptoms by nearly 20 percent, saving $70 million/year in drug costs alone