“Nearly unnecessary prescribing of antibiotics in primary care

“Nearly 85-90% of antibiotics are prescribed in primary
care and 50% of that is either unnecessary or questionable”18. There is a large variation in
countries in antibiotic prescribing rates which are often unexplained due to
the differences in epidemiology18. For a behavioral intervention to
be effective it must multifaceted. This study discusses the procedure for a
practical, randomized evaluation of interventions geared to decrease unnecessary
prescribing of antibiotics in primary care physicians identical to the study
mentioned above18. This study is Social Learning Theory based
combined with a learning program called STAR Educational program. The Social
learning theory is a combination of the Cognitive Learning Theory which states
that learning is influenced by psychological factors and Behavioral Learning
Theory which assumes that learning is based on environmental factors18. The
‘why of change’ is tackled by providing physicians their own submitted sample
information on antibiotic resistance and their own prescribing data to reflect
upon18. The ‘how of change’ is tackled by communication skills
training and information on the effects of antibiotics and choice18.
The trial evaluates 60 physicians’ practices. The primary result of the study
is to determine number of antibiotics prescribed over a year as well as a cost
effectiveness analysis which will identify the influence on the length of
consultation18. Also, education is a cost which benefits over time 18.

             This study
discusses how effective theory-based intervention including a learning program
which stresses on the reflection habits of physicians prescribing antibiotics and
AMR, as well as using consulting strategies while communicating with patients
about common infections. The STAR Educational program offered a course which
was about 5 hours long. The course used many learning methods such as
didactics, interactive, group reflective learning as well as individuals. The
courses focused on 2 themes: 1). Practice prescribing and resistance and 2).
Achieving consistency in patient consultation by handling everyday challenges18.
Again, this study consisted of 7 parts like the study stated above.

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             Some of the strengths of this study
included that they could look at dispensing data before and after the study to
evaluate changes in behavior. The yearlong study will allow assessment and a
stronger analysis to measure the effect of the intervention. A limitation to
this study is protecting against bias. Having access to the intervention can
motivate the volunteers, those allocated for the study maybe disappointed.