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Table 1 Randomized Controlled Trials Demonstrating Decreased Antibiotic Prescription Rates in Response to Patient- or Public- Centered Educational Interventions

From: Communication interventions to promote the public’s awareness of antibiotics: a systematic review

Location of Intervention (years observed)

Setting

Patient Education

Provider Education

Outcome Measure

Prescription Rate Change

Control

(Full) Intervention

Intervention Effect

P value (intervention effect compared to control)

Utah, Idaho (2001–2005) [45]

Rural Communities

Educational messages in examination rooms, pharmacies, newspapers, mailings. Key messages included “Do not treat viral infections with antibiotics”, how to manage respiratory tract infections, and ways to improve communication with the doctor

Computer decision support for treatment recommendations

Total Prescriptions /100 person-years

2.6 (95%CI[−3.7,9.4])

−8.8 (95% CI[−13.2,-4.2])

Not reported

Not reported

Massachusetts, Northwest Washington State (1996–1998) [27]

Managed Care Organization (MCO) Practices

CDC brochure mailings, waiting room materials

Meetings, CDC recommendations, feedback of prescribing rates

Children 3 to < 36 mo. old (antibiotics/person-year)

−11.5% (P < .0001)

−18.6% (P < .0001)

−16% (95%CI[− 8,-23%])a

< 0.01

Children 36 to < 72 mo. old (antibiotics/person-year)

−9.7% (P < .0001)

−15% (P < .0001)

−12% (95%CI[− 2,-21%])a

< 0.01

Massachusetts (2000–2003) [28]

Community-wide

Materials consistent with CDC principles regarding antibiotic indications and resistance were distributed to offices, pharmacies, child care, and by mail

Kickoff dinners and educational materials, feedback about prescribing practices

Children 24 to < 48 months (antibiotics/person-year)

− 10.30%

−14.50%

−4.20%

< 0.01

Children 48 to < 78 months (antibiotics/person-year)

−2.50%

−9.30%

−6.70%

< 0.0001

US Regions (2003–2005) [42]

Veterans Administration (VA) and non-VA emergency departments

CDC waiting room posters and brochures, interactive computer kiosk for information about viral infections

Educational sessions on judicious use, emphasizing CDC principles. Site-specific performance feedback

Antibiotics for Respiratory Tract Infections and Acute Bronchitis

0.5% (95%CI[− 3,5%])

−10% (95%CI[− 18,-2%])

Not reported

Not reported

  1. a Adjusted for baseline prescribing rates and other cofounders [27]