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:

Nearly half of adults mistakenly think benefits of daily aspirin outweigh risks

Cardiovascular disease medications underused globally

Amazon Pharmacy's RxPass program improves medication adherence, helps prime members save money, study finds

Tufts University School of Medicine, ATI Physical Therapy launch first-of-its-kind collaboration to make physical therapy education and career advancement more accessible and affordable

Could lycopene—a plant extract—be an effective antidepressant?

Study shows urine test for prostate cancer could be used at home

Shaping future of displays: clay/europium-based technology offers dual-mode versatility

Optimizing ADHD treatment: revealing key components of cognitive–behavioral therapy

Breaking barriers in thioxanthone synthesis: a double aryne insertion strategy

Houston Methodist researchers identify inhibitor drugs to treat aggressive breast cancer

Skin disease patients show response to targeted treatment

Tiny copper ‘flowers’ bloom on artificial leaves for clean fuel production

Cracks in Greenland Ice Sheet grow more rapidly in response to climate change

Computer model helps identify cancer-fighting immune cells key to immunotherapy

Keeper or corner?

Printable molecule-selective nanoparticles enable mass production of wearable biosensors

Mapping the yerba mate genome reveals surprising facts about the evolution of caffeine

Electricity prices across Europe to stabilise if 2030 targets for renewable energy are met, study suggests

Improved treatment timing reduces honey bee losses to Varroa mites

CAR-T cells can arm bystander T cells with CAR molecules via trogocytosis

Can ocean-floor mining oversights help us regulate space debris and mining on the Moon?

Observing ozonated water’s effectiveness against SARS-CoV-2 in saliva

Alcohol-related deaths up 18% during pandemic

Mothers of twins face a higher risk of heart disease in the year after birth

A new approach to detecting Alzheimer’s disease

Could the contraceptive pill reduce risk of ovarian cancer?

Launch of the most comprehensive, and up to date European Wetland Map

Lurie Children’s campaign urges parents to follow up right away if newborn screening results are abnormal

Does drinking alcohol really take away the blues? It's not what you think

Speed of risk perception is connected to how information is arranged

[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