Does Shared Decision-Making Help Cut Antibiotic Use?
(HealthDay News) — For patients with acute respiratory infections (ARIs), interventions that aim to facilitate shared decision-making reduce antibiotic use in primary care, according to a review published online Nov. 12 in The Cochrane Library.
Peter Coxeter, M.P.H., from Bond University in Gold Coast, Australia, and colleagues conducted a systematic review to examine how interventions that aim to facilitate share decision-making affect antibiotic prescribing for ARIs in primary care. Data were included from 10 published reports of nine original randomized controlled trials involving more than 1,100 primary care doctors and 492,000 patients.
The researchers found moderate quality evidence for a reduction in antibiotic use in primary care for interventions that aim to facilitate shared decision-making (immediately after or within six week), compared with usual care (47 to 29 percent decrease; risk ratio, 0.61). The reduction in prescribing was not associated with an increase in patient-initiated re-consultation or a decrease in patient satisfaction with the consultation. Insufficient data were available to examine the impact of the intervention on the sustained reduction in antibiotic prescribing, adverse clinical outcomes, or measures of patient and caregiver involvement in shared decision-making.
"Interventions that aim to facilitate shared decision-making reduce antibiotic prescribing in primary care in the short term," the authors write. "More evidence is needed to determine how any sustained reduction in antibiotic prescribing affects hospital admission, pneumonia and death."