Use of information campaigns and educational interventions directed to citizens and supported by physicians, aimed at promoting the appropriate use of medicines, have been evaluated by several studies with conflicting results. These interventions are potentially relevant, favouring the reduction of unnecessary use of medicines and related risks. Several studies have specifically evaluated the promotion of the appropriate use of antibiotics in adults and children, with variable results. A controlled study has been proposed to evaluate the feasibility and effectiveness of a multifaceted intervention aimed at reducing antibiotic prescription by increasing awareness on risks of their unnecessary use. Information has been provided to citizens through several media (posters, local TV, radio and newspapers, video terminals, websites of Local Health Authorities). Brochures with information on expected benefits and risks of antibiotics has also been available, either with direct access in waiting rooms and pharmacies or handed out and mediated by doctors. Physicians and pharmacists received specific data on local antibiotic resistance. A small group of representative doctors have also actively participated in defining the campaign key messages. A sample of general practitioners and paediatricians have been trained in patient counselling strategies. The information campaign has been implemented in two Provinces of Emilia-Romagna during the fall-winter season (November 2011-February 2012). Change in the overall prescribing rate of antibiotics (expressed as DDD per 1000 inhabitants/day) in the intervention area will be compared versus other areas in the same Region. Knowledge and attitudes of the general population will be evaluated through a phone and internet survey on a representative sample. This study could observe a reduction lower than 5% in the prescribing rate of antibiotics.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Masking
NONE
Following is the description of the multifaceted intervention: * brochures targeted at the general population and available in general practices, pharmacies, local health services and on the web (also translated in eight languages) * posters (same distribution as brochures) * short videos transmitted in local TVs, websites of Local Health Authorities and in video terminals in some pharmacies * radio-spots transmitted in local radio stations * advertisements in local newspapers * banners on websites of local newspapers * newsletter on antibiotic resistance in Emilia- Romagna, available to physicians and pharmacists * training courses in counselling strategies, directed to a subgroup of GPs and paediatricians
Local Health Authority of Modena
Modena, Italy
Local Health Authority of Parma
Parma, Italy
Prescribing rate of antibiotics
Cumulative five-month changes in DDD per 1000 inhabitants/day of specific classes of antibiotics (J01C, J01D, J01F, J01M ATC codes) in general practice
Time frame: up to 03/12
Antibiotic prescribing trends
Changes in antibiotic prescribing trends in eighteen months (same ATCs as for primary outcome)
Time frame: up to 04/13
Antibiotic expenditure
Changes in antibiotic expenditure per 1000 inhabitants/day (same ATCs as for primary outcome)
Time frame: up to 03/12
Knowledge/attitudes of the general population
Knowledge of and attitudes about the campaign messages, through a telephone and internet survey on a sample of the target population.
Time frame: up to 02/12
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