• Logo
  • HamaraJournals

Evaluation of the effect of informing patients through text messaging on antibiotic prescription by physicians in outpatient setting: a study protocol

Hassan Vakili Arki, Ehsan Nabovati, Mohammad Reza Saberi, Pourya Eslami, Zhila Taherzadeh, Saeid Eslami
69

Views


Abstract

Introduction: Irrational prescription of antibiotics has become a major global concern, and not only does it have health-related consequences, but it also affects countries’ overall economy. Based on reports and studies, antibiotics are prescribed in approximately 50% of prescriptions in Iran which can demand by patients as a major cause. It is anticipated that increasing the awareness and understanding of both physicians and patients, regarding the antibiotic use and resistance, could play an important role in the rational prescription of antibiotic medications. In this study, we will examine the effect of informing patients via text message right before their appointment on the proportion of prescribed antibiotic medications.

Material and Methods: In this study, a randomized control trial (RCT) will be conducted. The setting in which the study will be carry out, consists of 64 physicians (29 general physician and 35 specialist). Unit of randomization will be physicians based on the proportion of their prescriptions that include antibiotic medications (PIA). The first arm of the study is the intervention group, which consists of the patients receiving three text messages in the clinic’s waiting rooms. The second arm is the control group, and consists of the patients who won’t be receiving any text messages. The content of the text messages focuses on the consequences of self-medication with antibiotics, the fact that the use of antibiotics is not an option for curing viral diseases including cold, and it also asks the patients not to demand antibiotics by trusting their physicians.

Results: The main variable that will be measured is the proportion of prescriptions that include antibiotic medications.

Conclusion: This trial will be the first one to evaluate the patients’ role in the proportion of prescriptions that include antibiotic medications. It is hypothesized that patients’ demand for antibiotic medication is one of the main causes of irrational antibiotic prescription by physicians.

References

Masoumiasl H. Antibiotics are the scourge of Iranian lives [Internet]. 2012 [cited: 15 Dec 2020]. Available from: http://www.resalatnews.com/Fa/?code=97642

Gould IM, Jappy B. Trends in hospital antibiotic prescribing after introduction of an antibiotic policy. The Journal of Antimicrobial Chemotherapy. 1996; 38(5): 895-904. PMID: 8961062 DOI: 10.1093/jac/38.5.895

Anglim AM, Klym B, Byers KE, Scheld WM, Farr BM. Effect of a vancomycin restriction policy on ordering practices during an outbreak of vancomycin-resistant Enterococcus faecium. Arch Intern Med. 1997; 157(10): 1132-6. PMID: 9164379

Samore MH, Bateman K, Alder SC, Hannah E, Donnelly S, Stoddard GJ, et al. Clinical decision support and appropriateness of antimicrobial prescribing: A randomized trial. JAMA. 2005; 294(18): 2305-14. PMID: 16278358 DOI: 10.1001/jama.294.18.2305

Binder S, Levitt AM. Preventing emerging infectious diseases: A strategy for the 21st century. US Department of Health and Human Services, Centers for Disease Control and Prevention; 1998.

Ashiru-Oredope D, Sharland M, Charani E, McNulty C, Cooke J. Improving the quality of antibiotic prescribing in the NHS by developing a new antimicrobial stewardship programme: Start smart—Then focus. J Antimicrob Chemother. 2012; 67(suppl 1): i51-63. PMID: 22855879 DOI: 10.1093/jac/dks202

Zenner D, Shetty N. European antibiotic awareness day 2011: Antibiotics--A powerful tool and a dwindling resource. Fam Pract. 2011; 28(5): 471-3. PMID: 21926061 DOI: 10.1093/fampra/cmr075

Abdollahiasl A, Kebriaeezadeh A, Nikfar S, Farshchi A, Ghiasi G, Abdollahi M. Patterns of antibiotic consumption in Iran during 2000-2009. Int J Antimicrob Agents. 2011; 37(5): 489-90. PMID: 21419606 DOI: 10.1016/j.ijantimicag.2011.01.022

Cheraghali A, Nikfar S, Behmanesh Y, Rahimi V, Habibipour F, Tirdad R, et al. Evaluation of availability, accessibility and prescribing pattern of medicines in the Islamic Republic of Iran. East Mediterr Health J. 2004; 10(3): 406-15. PMID: 16212218

Butler CC, Rollnick S, Pill R, Maggs-Rapport F, Stott N. Understanding the culture of prescribing: Qualitative study of general practitioners' and patients' perceptions of antibiotics for sore throats. BMJ. 1998; 317(7159): 637-42. PMID: 9727992 DOI: 10.1136/bmj.317.7159.637

Mangione-Smith R, McGlynn EA, Elliott MN, McDonald L, Franz CE, Kravitz RL. Parent expectations for antibiotics, physician-parent communication, and satisfaction. Arch Pediatr Adolesc Med. 2001; 155(7): 800-6. PMID: 11434847 DOI: 10.1001/archpedi.155.7.800

Garjani A, Salimnejad M, Shamsmohamadi M, Baghchevan V, Vahidi R, Maleki-Dijazi N, et al. Effect of interactive group discussion among physicians to promote rational prescribing. East Mediterr Health J. 2009; 15(2): 408-15. PMID: 19554988

Dellit TH, Owens RC, McGowan JE, Gerding DN, Weinstein RA, Burke JP, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007; 44(2): 159-77. PMID: 17173212 DOI: 10.1086/510393

MacDougall C, Polk RE. Antimicrobial stewardship programs in health care systems. Clin Microbiol Rev. 2005; 18(4): 638-56. PMID: 16223951 DOI: 10.1128/CMR.18.4.638-656.2005

Wentzel J, van Velsen L, van Limburg M, de Jong N, Karreman J, Hendrix R, et al. Participatory eHealth development to support nurses in antimicrobial stewardship. BMC Med Inform Decis Mak. 2014; 14: 45. PMID: 24898694 DOI: 10.1186/1472-6947-14-45

Cals JW, Boumans D, Lardinois RJ, Gonzales R, Hopstaken RM, Butler CC, et al. Public beliefs on antibiotics and respiratory tract infections: An internet-based questionnaire study. Br J Gen Pract. 2007; 57(545): 942-7. PMID: 18252068 DOI: 10.3399/096016407782605027

Welschen I, Kuyvenhoven MM, Hoes AW, Verheij TJ. Effectiveness of a multiple intervention to reduce antibiotic prescribing for respiratory tract symptoms in primary care: Randomised controlled trial. BMJ. 2004; 329(7463): 431. PMID: 15297305 DOI: 10.1136/bmj.38182.591238.EB

Soleymani F, Rashidian A, Dinarvand R, Kebriaeezade A, Hosseini M, Abdollahi M. Assessing the effectiveness and cost-effectiveness of audit and feedback on physician’s prescribing indicators: Study protocol of a randomized controlled trial with economic evaluation. Daru. 2012; 20(1): 1-7. PMID: 23351564 DOI: 10.1186/2008-2231-20-88

Simpson SA, Butler CC, Hood K, Cohen D, Dunstan F, Evans MR, et al. Stemming the tide of antibiotic resistance (STAR): A protocol for a trial of a complex intervention addressing the 'why' and 'how' of appropriate antibiotic prescribing in general practice. BMC Fam Pract. 2009; 10: 20. PMID: 19309493 DOI: 10.1186/1471-2296-10-20

Sintchenko V, Iredell JR, Gilbert GL, Coiera E. Handheld computer-based decision support reduces patient length of stay and antibiotic prescribing in critical care. J Am Med Inform Assoc. 2005; 12(4): 398-402. PMID: 15802478 DOI: 10.1197/jamia.M1798

Christakis DA, Zimmerman FJ, Wright JA, Garrison MM, Rivara FP, Davis RL. A randomized controlled trial of point-of-care evidence to improve the antibiotic prescribing practices for otitis media in children. Pediatrics. 2001; 107(2): E15. PMID: 11158489 DOI: 10.1542/peds.107.2.e15

Free C, Phillips G, Galli L, Watson L, Felix L, Edwards P, et al. The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: A systematic review. PLoS Med. 2013; 10(1): e1001362. PMID: 23349621 DOI: 10.1371/journal.pmed.1001362

Buhi ER, Trudnak TE, Martinasek MP, Oberne AB, Fuhrmann HJ, McDermott RJ. Mobile phone-based behavioural interventions for health: A systematic review. Health Education Journal. 2013; 72(5): 564-83.

Patrick K, Raab F, Adams M, Dillon L, Zabinski M, Rock C, et al. A text message-based intervention for weight loss: Randomized controlled trial. J Med Internet Res. 2009; 11(1): e1. PMID: 19141433 DOI: 10.2196/jmir.1100

Nejad AS, Noori MRF, Haghdoost AA, Bahaadinbeigy K, Abu-Hanna A, Eslami S. The effect of registry-based performance feedback via short text messages and traditional postal letters on prescribing parenteral steroids by general practitioners: A randomized controlled trial. Int J Med Inform. 2016; 87: 36-43. PMID: 26806710 DOI: 10.1016/j.ijmedinf.2015.12.008




DOI: http://dx.doi.org/10.30699/fhi.v10i1.281

Refbacks

  • There are currently no refbacks.