Patient Centered Communication Training to Reduce Antibiotic Use in Acute Respiratory Tract Infections

Multidimensional Intervention Program to Reduce Antibiotic Prescriptions for Acute Respiratory Tract Infections in Adults: a Randomized Controlled Trial in Primary Care

The purpose of this study is to evaluate the effectiveness of a short training program for general practitioners in patient-centered communication to reduce antibiotic prescription for acute respiratory tract infections (ARTI).

Acute respiratory tract infections (ARTI) constitute the most frequent reason for seeking ambulatory care and for the prescription of antibiotics, despite the mostly viral origin of ARTI. Antibiotic prescriptions for ARTI increase unnecessary drug expenditures and are the main reason for increasing drug resistance of common bacteria. Evidence from intervention studies shows that merely providing physicians with guidelines and educational material for the management of acute respiratory tract infections is not enough to reduce antibiotic prescriptions for these conditions. The main reasons for antibiotic prescription in ARTI are non-medical and related to the physician patient relationship, patients' expectations and beliefs about the benefit of antibiotics. Therefore patient-centered communication could be a promising approach to reduce the rate of antibiotic prescription in ambulatory care.

Comparison: General practitioners (GPs) trained in patient-centered communication in addition to evidence-based guidelines for diagnosis and treatment of ARTI compared to GPs just introduced to evidence-based guidelines.

Inclusion Criteria:

• 18 years or older
• Symptoms of an acute respiratory tract infection for >1 and <28 days

Exclusion Criteria:

• Patients without informed consent
• Not fluent in German
• Patients with a psychiatric disorder
• Patients with a recurrent respiratory system infection with antibiotic treatment in the previous 4 weeks