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首页> 外文期刊>Scandinavian journal of primary health care. >Effect of educational outreach on general practice prescribing of antibiotics and antidepressants: A two-year randomised controlled trial
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Effect of educational outreach on general practice prescribing of antibiotics and antidepressants: A two-year randomised controlled trial

机译：教育推广对普通处方抗生素和抗抑郁药的影响：一项为期两年的随机对照试验

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Objective. Prescribing of broad spectrum antibiotics and antidepressants in general practice often does not accord with guidelines. The aim was to determine the effectiveness of educational outreach in improving the prescribing of selected antibiotics and antidepressants, and whether the effect is sustained for two years. Design. Single blind randomized trial. Setting. Twenty-eight general practices in Leicestershire, England. Intervention. Educational outreach visits were undertaken, tailored to barriers to change, 14 practices receiving visits for reducing selected antibiotics and 14 for improving antidepressant prescribing. Main outcome measures. Number of items prescribed per 1000 registered patients for amoxicillin with clavulanic acid (co-amoxiclav) and quinolone antibiotics, and average daily quantities per 1000 patients for lofepramine and fluoxetine antidepressants, measured at the practice level for six-month periods over two years. Results. There was no effect on the prescribing of co-amoxiclav, quinolones, or fluoxetine, but prescribing of lofepramine increased in accordance with the guidelines. The increase persisted throughout two years of follow-up. Conclusion. A simple, group-level educational outreach intervention, designed to take account of identified barriers to change, can have a modest but sustained effect on prescribing levels. However, outreach is not always effective. The context in which change in prescribing practice is being sought, the views of prescribers concerning the value of the drug, or other unrecognised barriers to change may influence the effectiveness of outreach.
机译：目的。在一般实践中开出广谱抗生素和抗抑郁药的处方通常不符合指导原则。目的是确定教育宣传在改进所选抗生素和抗抑郁药处方方面的有效性，以及该效果是否可持续两年。设计。单盲随机试验。设置。英格兰莱斯特郡的28种常规做法。介入。针对变化的障碍进行了教育外访，针对14种做法接受了减少选择的抗生素的拜访，并针对14种改善了抗抑郁药的处方进行了拜访。主要观察指标。每1000名登记的阿莫西林，克拉维酸（co-amoxiclav）和喹诺酮类抗生素的处方项目数，以及每1000例洛非帕明和氟西汀抗抑郁药的平均每日服用量，在实践水平下为期六个月，为期两年。结果。对co-amoxiclav，喹诺酮或氟西汀的处方没有影响，但根据指南增加了洛非拉明的处方。这种增加持续了两年。结论。一种简单的小组级教育推广干预措施，旨在考虑已确定的变革障碍，可以对处方水平产生适度但持续的影响。但是，外联并不总是有效的。在寻求改变处方实践的背景，处方者对药物价值的看法或其他未认识到的改变障碍可能会影响推广的有效性。

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