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dc.contributor.authorVellinga, Akke
dc.contributor.authorGalvin, Sandra
dc.contributor.authorDuane, Sinead
dc.contributor.authorCallan, Aoife
dc.contributor.authorBennett, Kathleen
dc.contributor.authorCormican, Martin
dc.contributor.authorDomegan, Christine
dc.contributor.authorMurphy, Andrew W.
dc.date.accessioned2017-06-28T08:55:36Z
dc.date.available2017-06-28T08:55:36Z
dc.date.issued2015-11-16
dc.identifier.citationVellinga, A,Galvin, S,Duane, S,Callan, A,Bennett, K,Cormican, M,Domegan, C,Murphy, AW (2016) 'Intervention to improve the quality of antimicrobial prescribing for urinary tract infection: a cluster randomized trial'. Canadian Medical Association journal, 188 :108-115. DOI: 10.1503/cmaj.150601en_IE
dc.identifier.issn0008-4409
dc.identifier.urihttp://hdl.handle.net/10379/6611
dc.description.abstractBackground: Overuse of antimicrobial therapy in the community adds to the global spread of antimicrobial resistance, which is jeopardizing the treatment of common infections.Methods: We designed a cluster randomized complex intervention to improve antimicrobial prescribing for urinary tract infection in Irish general practice. During a 3-month baseline period, all practices received a workshop to promote consultation coding for urinary tract infections. Practices in intervention arms A and B received a second workshop with information on antimicrobial prescribing guidelines and a practice audit report (baseline data). Practices in intervention arm B received additional evidence on delayed prescribing of antimicrobials for suspected urinary tract infection. A reminder integrated into the patient management software suggested first-line treatment and, for practices in arm B, delayed prescribing. Over the 6-month intervention, practices in arms A and B received monthly audit reports of antimicrobial prescribing.Results: The proportion of antimicrobial prescribing according to guidelines for urinary tract infection increased in arms A and B relative to control (adjusted overall odds ratio [OR] 2.3, 95% confidence interval [CI] 1.7 to 3.2; arm A adjusted OR 2.7, 95% CI 1.8 to 4.1; arm B adjusted OR 2.0, 95% CI 1.3 to 3.0). An unintended increase in antimicrobial prescribing was observed in the intervention arms relative to control (arm A adjusted OR 2.2, 95% CI 1.2 to 4.0; arm B adjusted OR 1.4, 95% CI 0.9 to 2.1). Improvements in guideline-based prescribing were sustained at 5 months after the intervention.Interpretation: A complex intervention, including audit reports and reminders, improved the quality of prescribing for urinary tract infection in Irish general practice.en_IE
dc.formatapplication/pdfen_IE
dc.language.isoenen_IE
dc.publisherCanadian Medical Association
dc.relation.ispartofCanadian Medical Association journalen
dc.subjectGeneral practiceen_IE
dc.subjectManagementen_IE
dc.subjectNitrofurantoinen_IE
dc.subjectResistanceen_IE
dc.subjectWomenen_IE
dc.titleIntervention to improve the quality of antimicrobial prescribing for urinary tract infection: a cluster randomized trialen_IE
dc.typeArticleen_IE
dc.date.updated2017-06-16T07:00:57Z
dc.identifier.doi10.1503/cmaj.150601
dc.local.publishedsourcehttp://dx.doi.org/10.1503/cmaj.150601en_IE
dc.description.peer-reviewedpeer-reviewed
dc.contributor.funder|~|
dc.internal.rssid10668832
dc.local.contactAkke Vellinga, General Practice/Bacteriology, Nui Galway. 5192 Email: akke.vellinga@nuigalway.ie
dc.local.copyrightcheckedNo
dc.local.versionACCEPTED
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