Effectiveness of a patient-based health education intervention in reducing antibiotic use for acute upper respiratory tract infections in the private sector primary care setting n Singapore. Yu, Y., Lee, H. M. M., Huang, J. H. X., Pan, S. T., Chen, M. I., Lim, F. S., Loh, V. W. K., Wong, C. S., & Goh, E. H. Annals of the Academy of Medicine Singapore, 44(10 SUPPL. 1):S264, 2015.
Effectiveness of a patient-based health education intervention in reducing antibiotic use for acute upper respiratory tract infections in the private sector primary care setting n Singapore [link]Paper  abstract   bibtex   
Background & Hypothesis: We investigated the effectiveness of patient-targeted education in reducing antibiotic prescriptions for upper respiratory tract infections (URTIs) amongst adults in the private primary care setting in Singapore. Method(s): Our randomised controlled trial enrolled patients aged 21 years and above presenting at GP (general practitioner) clinics with URTI symptoms for 7 days or less. Intervention arm patients were verbally educated via pamphlets about the aetiology of URTIs and role of antibiotics in treating URTIs. Control arm patients were educated on influenza vaccinations. Both arms were compared on proportions prescribed antibiotics and patients' postconsultation perceptions. Result(s): A total of 914 patients consulting 35 doctors from 24 clinics completed the study (457 in each arm). Demographics in both arms were similar. Out of these patients, 19.1% were prescribed an antibiotic, but this varied from 0% to 70% for individual GPs. The intervention did not significantly reduce antibiotic prescriptions (odds ratio [OR]: 1.20, 95% confidence intervals [CI], 0.84-1.72) except in patients of Indian ethnicity (OR: 0.32, 95% CI, 0.14-0.75). Intervention arm patients were more likely to agree that the education improved their understanding of URTI causes (Spearman's rho 0.13, P \textless0.001). However positive effects on the view that antibiotics were not needed most of the time for URTIs (Spearman's rho 0.20, P = 0.047) and being worried about the side effects of antibiotics (Spearman's rho 0.24, P = 0.018) were restricted to the Indian subgroup. Discussion & Conclusion(s): Our educational intervention was effective only in the Indian ethnic subgroup. Follow-up studies to investigate differences in responses to educational programmes between ethnicities, and to assess GPtargeted interventions, are recommended.
@article{yu_effectiveness_2015,
	title = {Effectiveness of a patient-based health education intervention in reducing antibiotic use for acute upper respiratory tract infections in the private sector primary care setting n {Singapore}},
	volume = {44},
	issn = {0304-4602},
	url = {http://www.annals.edu.sg/pdf/44VolNo10Oct2015/SHBC_Final_2.pdf http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed16&NEWS=N&AN=72150755},
	abstract = {Background \& Hypothesis: We investigated the effectiveness of patient-targeted education in reducing antibiotic prescriptions for upper respiratory tract infections (URTIs) amongst adults in the private primary care setting in Singapore. Method(s): Our randomised controlled trial enrolled patients aged 21 years and above presenting at GP (general practitioner) clinics with URTI symptoms for 7 days or less. Intervention arm patients were verbally educated via pamphlets about the aetiology of URTIs and role of antibiotics in treating URTIs. Control arm patients were educated on influenza vaccinations. Both arms were compared on proportions prescribed antibiotics and patients' postconsultation perceptions. Result(s): A total of 914 patients consulting 35 doctors from 24 clinics completed the study (457 in each arm). Demographics in both arms were similar. Out of these patients, 19.1\% were prescribed an antibiotic, but this varied from 0\% to 70\% for individual GPs. The intervention did not significantly reduce antibiotic prescriptions (odds ratio [OR]: 1.20, 95\% confidence intervals [CI], 0.84-1.72) except in patients of Indian ethnicity (OR: 0.32, 95\% CI, 0.14-0.75). Intervention arm patients were more likely to agree that the education improved their understanding of URTI causes (Spearman's rho 0.13, P {\textless}0.001). However positive effects on the view that antibiotics were not needed most of the time for URTIs (Spearman's rho 0.20, P = 0.047) and being worried about the side effects of antibiotics (Spearman's rho 0.24, P = 0.018) were restricted to the Indian subgroup. Discussion \& Conclusion(s): Our educational intervention was effective only in the Indian ethnic subgroup. Follow-up studies to investigate differences in responses to educational programmes between ethnicities, and to assess GPtargeted interventions, are recommended.},
	language = {English},
	number = {10 SUPPL. 1},
	journal = {Annals of the Academy of Medicine Singapore},
	author = {Yu, Y. and Lee, H. M. M. and Huang, J. H. X. and Pan, S. T. and Chen, M. I. and Lim, F. S. and Loh, V. W. K. and Wong, C. S. and Goh, E. H.},
	year = {2015},
	keywords = {*Singapore, *antibiotic agent, *health, *health education, *human, *organization and management, *patient, *primary medical care, *upper respiratory tract infection, Indian, adult, arm, confidence interval, education, ethnicity, etiology, follow up, general practitioner, hospital, hypothesis, influenza vaccination, physician, prescription, randomized controlled trial, risk, side effect},
	pages = {S264}
}

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