title: Theory-based interventions to reduce prescription of antibiotics--a randomized controlled trial in Sweden.
abstract: BACKGROUND
  Upper respiratory tract infections (URTIs) are the most common reason for consulting a GP and for receiving an antibiotic prescription, although evidence shows poor benefit but rather increasing antibiotic resistance. Interventions addressing physicians have to take into consideration the complexity of prescribing behaviour.
  
  
  OBJECTIVE
  To study whether interventions based on behavioural theories can reduce the prescribing of antibiotics against URTIs in primary care. Setting and subjects. GPs at 19 public primary health care centres in southern Sweden.
  
  
  METHODS
  We performed a randomized controlled study using two behavioural theory-based interventions, the persuasive communication intervention (PCI) and the graded task intervention (GTI), which emerged from social cognitive theory and operant learning theory. GPs were randomized to a control group or one of two intervention groups (PCI and GTI).
  
  
  METHODS
  Changes in the rate of prescription of antibiotics against URTIs in primary care patients of all ages and in patients aged 0-6 years.
  
  
  RESULTS
  No significant differences were seen in the prescription rates before and after the interventions when patients of all ages were analysed together. However, for patients aged 0-6 years, there was a significant lower prescription rate in the PCI group (P = 0.037), but not the GTI group, after intervention.
  
  
  CONCLUSIONS
  Theory-based interventions have limited impact on reducing the prescription of antibiotics against URTIs in primary care. Future studies are needed to draw firm conclusions about their effects.
authors: Primärvården Skåne, Laröd Health Care Centre, Helsingborg.
authors: Veronica
authors: V
authors: Milos
authors: Ulf
authors: U
authors: Jakobsson
authors: Tommy
authors: T
authors: Westerlund
authors: Eva
authors: E
authors: Melander
authors: Sigvard
authors: S
authors: Mölstad
authors: Patrik
authors: P
authors: Midlöv
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D035841:Behavioral Research; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D013548:Sweden
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; behavioural change interventions; primary health care; upper respiratory tract infections.