Program to improve antibiotic prescribing in primary care

Abstract

Many countries are trying to reduce prescription and use of antibiotics. This Chapter outlines a five-year program, implemented in Australia from 2013- 2018. The aim was to reduce antibiotic prescribing in primary care by 25% and there was a focus on the management of respiratory infections. Formative evaluation pointed to diagnostic uncertainty and patient expectation as important drivers of prescribing, and a series of key messages and interventions were designed to support both clinicians and patients to use fewer antibiotics. Messaging for health professionals and consumers included the concept that individuals can make a difference and that every prescription matters. Prescribing feedback (with and without audit components), patient action plans and use of media were included in the behavioural interventions. Program acceptance, changes in knowledge and attitudes and changes in prescribing were all trending very positively when the program had an interim evaluation in 2016. This included an overall reduction in antibiotic prescribing of 19%. In addition, ongoing evaluation proved useful in modifying and improving program delivery throughout implementation period.