Behavioral intervention and the use of performance analytic solutions can help reduce the unnecessary use of antibiotics for conditions that generally do not respond to such treatment.

d2i’s Performance Analytic Application can help your facility be a part of the solution to an alarming problem of overprescribing antibiotics.

In recent years, the United States has seen a problematic trend in the over-prescription of antibiotics. Overusing antibiotics can cause adverse effects in patients and can lead to the development of antibiotic-resistant bacteria — superbugs. Behavioral intervention and the use of performance analytic solutions can cut down on this problem.

Perils of Antibiotics Overuse

Reducing inappropriate use of antibiotics is essential to preventing antibiotic resistance and its consequences. According to the CDC, antibiotic-resistant infections affect roughly 2 million people in the U.S. alone and are associated with 23,000 deaths annually.

Certain respiratory conditions don’t respond to antibiotics and shouldn’t be treated with them. Those include the flu, viral pneumonia, asthma, allergies, cold, and bronchitis.

Antibiotic-resistant superbugs infect millions of people worldwide each year, setting the stage of a major public health crisis, perhaps sooner than we think. Studies show that nearly half of American outpatient antibiotic prescriptions are unnecessary. Other staggering findings include:

  • One study that showed that in 2010-2011, the estimated annual antibiotic prescription rate in the U.S. was 506 per 1,000; of these, an estimated 353 “were likely appropriate.”
  • Another study, which focused on the increasing number of urgent care clinics, found that nearly half of patients seeking treatment for a condition that doesn’t require the use of antibiotics (e.g., colds and flu) had received them anyway. This was three times as often as for patients seen for the same illnesses in traditional doctors’ offices.
  • Yet another study, published in 2017 by the Centers for Disease Control and Prevention and the Pew Charitable Trust, found that about 47 million antibiotic prescriptions (about a third) dispensed every year in EDs, doctors’ offices, clinics, and hospitals were not needed or not effective. This figure didn’t include retail clinics or urgent care centers, where more and more patients are seeking treatment.

Monitoring and Tracking as Effective Solutions

The health care industry must commit itself to ensuring appropriate prescribing of antibiotics, as well as managing patient outcomes and expectations. One initiative that has proved effective is tracking and reporting based on audits and feedback with peer comparisons. A CDC web page, most recently updated in September of last year, shows the results of a number of cluster-randomized controlled trials with participants ranging from hospital EDs to primary care practices to pediatric facilities.

Methods included auditing and monitoring antibiotic prescribing practices, clinician education, providing regular feedback, self-assessment of prescribing practices, peer comparison, and educational intervention.

The results were positive, including:

  • A decrease in prescription of non-recommended broad-spectrum antibiotics
  • A reduction in unnecessary prescription of antibiotics for acute respiratory tract infections
  • Reductions in antibiotic dispensing with no change in hospital admissions, return visits, or costs.

A recent report, published by the Journal of General Internal Medicine, also showed that the number of unnecessary antibiotic prescriptions can be reduced by three behavioral economics interventions, including peer comparison. This involved sending clinicians emails showing how their prescribing rates stacked up against their colleagues’. The other two were suggesting alternative treatments that don’t use antibiotics and requiring prescribers to justify their use of antibiotics in the patient’s EHR.

Using Analytics to Reduce Antibiotics Prescription

Part of the successful strategy to reduce the number of unnecessary antibiotic prescriptions is compliance with established prescribing protocols. With d2i’s analytic performance solutions, HCOs can monitor prescribing practices among their providers and identify outliers. d2i allows transparent monitoring of physicians and site compliance, and can help identify practice patterns and variability. Visit our resources on monitoring adherence to protocols and reducing practice variability, or schedule a 30-minute demo to learn how we can help your department reduce unnecessary antibiotic prescriptions.

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