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At the international level, several experiments have been conducted to modify antibiotic prescribing practices in GPs. The mere development of training or the mere provision of information on the internet do not seem to change the practices when these interventions are conducted in isolation. On the other hand, various approaches involving communication training, specific educational interventions working on ideas received from examples, interventions at the point of care, and the use of electronic decision support systems have demonstrated beneficial effects on prescription. The fact of sending feedback on their prescribing practices back to GPs also showed an impact
The Antibioclic website was created in 2011. It is an internet tool for prescribing help developed for general practitioners. Every day, it is consulted on average by 9000 health professionals. One question is how far the use of the site makes it possible to modify prescribing practices, which would justify, if need be, to actively promote it to general practitioners who do not use it. (The council of the order of doctors counted a little more than 88000 general practitioners in 2018.)
One challenge would be to implement a strategy:
The proposed study will thus experiment with an intervention modality based on the visit of a medical representative in general practitioner facilities, with:
The generalizability of the intervention will be based on the collaboration with the medical representatives , which already intervene in an operational and regular way on this topic on the whole France. The medical representatives, distributed throughout the country, provide regular visits to the GPs and promote good practices. This type of visit to GPs is original internationally, demonstrating its impact on practices is decisive.
The purpose of the research is to compare the effect on antibiotic prescriptions made by general practitioners after 12 months of follow-up, i) an intervention led by the medical representatives in general practitioner facilities, the intervention involving usual visit (antibiotic resistance sensitization, work on preconceived ideas, feedback on practices) and demonstration of the use of Antibioclic, ii) an intervention conducted on the same terms by the the medical representatives but without Antibioclic demonstration, iii) compared to usual practice.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 1 | Experimental | Medical representative presentation with the help internet tool for decision ANTIBIOCLIC |
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| Arm 2 | Experimental | Medical representative presentation without presentation of the internet tool for decision support |
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| Arm 3 | No Intervention | Usual practice without intervention regarding the prescription of antibiotics |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Visit to GPs to promote good antibiotic prescription with the help internet tool for decision: ANTIBIOCLIC | Other | Visit to GPs to promote good antibiotic prescription with the help internet tool for decision: ANTIBIOCLIC |
| Measure | Description | Time Frame |
|---|---|---|
| The primary endpoint will be the overall volume of antibiotics delivered in Defined Daily Dose (DDD) per participating GP, after 12 months of follow-up. | 12 months |
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Inclusion Criteria:
Exclusion Criteria:
Will not be included attending GPs
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital | Nantes | 44000 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39693139 | Derived | Jeanmougin P, Larramendy S, Fournier JP, Gaultier A, Rat C. Effect of a Feedback Visit and a Clinical Decision Support System Based on Antibiotic Prescription Audit in Primary Care: Multiarm Cluster-Randomized Controlled Trial. J Med Internet Res. 2024 Dec 18;26:e60535. doi: 10.2196/60535. |
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| Visit to GPs to promote good antibiotic prescription without presentation of the internet tool for decision support | Other | Visit to GPs to promote good antibiotic prescription without presentation of the internet tool for decision support |
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