Changing the Antibiotic Prescribing of general practice registrars: The ChAP study protocol for a prospective controlled study of a multimodal educational intervention

Mieke L. Van Driel; Simon Morgan; Amanda Tapley; Lawrie McArthur; Patrick McElduff; Lucy Yardley; Anthea Dallas; Laura Deckx; Katie Mulquiney; Joshua S. Davis; Andrew Davey; Kim Henderson; Paul Little; Parker J. Magin

doi:10.1186/s12875-016-0470-7

Changing the Antibiotic Prescribing of general practice registrars: The ChAP study protocol for a prospective controlled study of a multimodal educational intervention

Mieke L. Van Driel, Simon Morgan, Amanda Tapley, Lawrie McArthur, Patrick McElduff, Lucy Yardley, Anthea Dallas, Laura Deckx, Katie Mulquiney, Joshua S. Davis, Andrew Davey, Kim Henderson, Paul Little, Parker J. Magin

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Abstract

Background: Australian General Practitioners (GPs) are generous prescribers of antibiotics, prompting concerns including increasing antimicrobial resistance in the community. Recent data show that GPs in vocational training have prescribing patterns comparable with the high prescribing rate of their established GP supervisors. Evidence-based guidelines consistently advise that antibiotics are not indicated for uncomplicated upper respiratory tract infections (URTI) and are rarely indicated for acute bronchitis. A number of interventions have been trialled to promote rational antibiotic prescribing by established GPs (with variable effectiveness), but the impact of such interventions in a training setting is unclear. We hypothesise that intervening while early-career GPs are still developing their practice patterns and prescribing habits will result in better adherence to evidence-based guidelines as manifested by lower antibiotic prescribing rates for URTIs and acute bronchitis.

Methods/design: The intervention consists of two online modules, a face-to-face workshop for GP trainees, a face-to-face workshop for their supervisors and encouragement for the trainee-supervisor dyad to include a case-based discussion of evidence-based antibiotic prescribing in their weekly one-on-one teaching meetings. We will use a non-randomised, non-equivalent control group design to assess the impact on antibiotic prescribing for acute upper respiratory infections and acute bronchitis by GP trainees in vocational training.

Discussion: Early-career GPs who are still developing their clinical practice and prescribing habits are an underutilized target-group for interventions to curb the growth of antimicrobial resistance in the community. Interventions that are embedded into existing training programs or are linked to continuing professional development have potential to increase the impact of existing interventions at limited additional cost.

Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12614001209684 (registered 17/11/2014).

Original language	English
Article number	67
Pages (from-to)	1-8
Number of pages	8
Journal	BMC Family Practice
Volume	17
DOIs	https://doi.org/10.1186/s12875-016-0470-7
Publication status	Published - 6 Jun 2016

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Van Driel, M. L., Morgan, S., Tapley, A., McArthur, L., McElduff, P., Yardley, L., Dallas, A., Deckx, L., Mulquiney, K., Davis, J. S., Davey, A., Henderson, K., Little, P., & Magin, P. J. (2016). Changing the Antibiotic Prescribing of general practice registrars: The ChAP study protocol for a prospective controlled study of a multimodal educational intervention. BMC Family Practice, 17, 1-8. [67]. https://doi.org/10.1186/s12875-016-0470-7

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title = "Changing the Antibiotic Prescribing of general practice registrars: The ChAP study protocol for a prospective controlled study of a multimodal educational intervention",

abstract = "Background: Australian General Practitioners (GPs) are generous prescribers of antibiotics, prompting concerns including increasing antimicrobial resistance in the community. Recent data show that GPs in vocational training have prescribing patterns comparable with the high prescribing rate of their established GP supervisors. Evidence-based guidelines consistently advise that antibiotics are not indicated for uncomplicated upper respiratory tract infections (URTI) and are rarely indicated for acute bronchitis. A number of interventions have been trialled to promote rational antibiotic prescribing by established GPs (with variable effectiveness), but the impact of such interventions in a training setting is unclear. We hypothesise that intervening while early-career GPs are still developing their practice patterns and prescribing habits will result in better adherence to evidence-based guidelines as manifested by lower antibiotic prescribing rates for URTIs and acute bronchitis. Methods/design: The intervention consists of two online modules, a face-to-face workshop for GP trainees, a face-to-face workshop for their supervisors and encouragement for the trainee-supervisor dyad to include a case-based discussion of evidence-based antibiotic prescribing in their weekly one-on-one teaching meetings. We will use a non-randomised, non-equivalent control group design to assess the impact on antibiotic prescribing for acute upper respiratory infections and acute bronchitis by GP trainees in vocational training. Discussion: Early-career GPs who are still developing their clinical practice and prescribing habits are an underutilized target-group for interventions to curb the growth of antimicrobial resistance in the community. Interventions that are embedded into existing training programs or are linked to continuing professional development have potential to increase the impact of existing interventions at limited additional cost. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12614001209684 (registered 17/11/2014).",

keywords = "Antibacterial agents, Drug resistance, Evidence-based medicine, General practice, Graduate medical education, Physician prescribing patterns",

author = "{Van Driel}, {Mieke L.} and Simon Morgan and Amanda Tapley and Lawrie McArthur and Patrick McElduff and Lucy Yardley and Anthea Dallas and Laura Deckx and Katie Mulquiney and Davis, {Joshua S.} and Andrew Davey and Kim Henderson and Paul Little and Magin, {Parker J.}",

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Van Driel, ML, Morgan, S, Tapley, A, McArthur, L, McElduff, P, Yardley, L, Dallas, A, Deckx, L, Mulquiney, K, Davis, JS, Davey, A, Henderson, K, Little, P & Magin, PJ 2016, 'Changing the Antibiotic Prescribing of general practice registrars: The ChAP study protocol for a prospective controlled study of a multimodal educational intervention', BMC Family Practice, vol. 17, 67, pp. 1-8. https://doi.org/10.1186/s12875-016-0470-7

TY - JOUR

T1 - Changing the Antibiotic Prescribing of general practice registrars

T2 - The ChAP study protocol for a prospective controlled study of a multimodal educational intervention

AU - Van Driel, Mieke L.

AU - Morgan, Simon

AU - Tapley, Amanda

AU - McArthur, Lawrie

AU - McElduff, Patrick

AU - Yardley, Lucy

AU - Dallas, Anthea

AU - Deckx, Laura

AU - Mulquiney, Katie

AU - Davis, Joshua S.

AU - Davey, Andrew

AU - Henderson, Kim

AU - Little, Paul

AU - Magin, Parker J.

PY - 2016/6/6

Y1 - 2016/6/6

N2 - Background: Australian General Practitioners (GPs) are generous prescribers of antibiotics, prompting concerns including increasing antimicrobial resistance in the community. Recent data show that GPs in vocational training have prescribing patterns comparable with the high prescribing rate of their established GP supervisors. Evidence-based guidelines consistently advise that antibiotics are not indicated for uncomplicated upper respiratory tract infections (URTI) and are rarely indicated for acute bronchitis. A number of interventions have been trialled to promote rational antibiotic prescribing by established GPs (with variable effectiveness), but the impact of such interventions in a training setting is unclear. We hypothesise that intervening while early-career GPs are still developing their practice patterns and prescribing habits will result in better adherence to evidence-based guidelines as manifested by lower antibiotic prescribing rates for URTIs and acute bronchitis. Methods/design: The intervention consists of two online modules, a face-to-face workshop for GP trainees, a face-to-face workshop for their supervisors and encouragement for the trainee-supervisor dyad to include a case-based discussion of evidence-based antibiotic prescribing in their weekly one-on-one teaching meetings. We will use a non-randomised, non-equivalent control group design to assess the impact on antibiotic prescribing for acute upper respiratory infections and acute bronchitis by GP trainees in vocational training. Discussion: Early-career GPs who are still developing their clinical practice and prescribing habits are an underutilized target-group for interventions to curb the growth of antimicrobial resistance in the community. Interventions that are embedded into existing training programs or are linked to continuing professional development have potential to increase the impact of existing interventions at limited additional cost. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12614001209684 (registered 17/11/2014).

AB - Background: Australian General Practitioners (GPs) are generous prescribers of antibiotics, prompting concerns including increasing antimicrobial resistance in the community. Recent data show that GPs in vocational training have prescribing patterns comparable with the high prescribing rate of their established GP supervisors. Evidence-based guidelines consistently advise that antibiotics are not indicated for uncomplicated upper respiratory tract infections (URTI) and are rarely indicated for acute bronchitis. A number of interventions have been trialled to promote rational antibiotic prescribing by established GPs (with variable effectiveness), but the impact of such interventions in a training setting is unclear. We hypothesise that intervening while early-career GPs are still developing their practice patterns and prescribing habits will result in better adherence to evidence-based guidelines as manifested by lower antibiotic prescribing rates for URTIs and acute bronchitis. Methods/design: The intervention consists of two online modules, a face-to-face workshop for GP trainees, a face-to-face workshop for their supervisors and encouragement for the trainee-supervisor dyad to include a case-based discussion of evidence-based antibiotic prescribing in their weekly one-on-one teaching meetings. We will use a non-randomised, non-equivalent control group design to assess the impact on antibiotic prescribing for acute upper respiratory infections and acute bronchitis by GP trainees in vocational training. Discussion: Early-career GPs who are still developing their clinical practice and prescribing habits are an underutilized target-group for interventions to curb the growth of antimicrobial resistance in the community. Interventions that are embedded into existing training programs or are linked to continuing professional development have potential to increase the impact of existing interventions at limited additional cost. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12614001209684 (registered 17/11/2014).

KW - Antibacterial agents

KW - Drug resistance

KW - Evidence-based medicine

KW - General practice

KW - Graduate medical education

KW - Physician prescribing patterns

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Changing the Antibiotic Prescribing of general practice registrars: The ChAP study protocol for a prospective controlled study of a multimodal educational intervention

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