To view this email as a webpage click here
Strictly Embargoed Until 00.01 Hours (GMT), Thursday, November 12, 2015
[19.01 Hours US Eastern Time, Wednesday, November 11]
Media contacts:
Wiley
Dawn Peters (US): +1 781-388-8408
sciencenewsroom@wiley.com
Cochrane Library
Cochrane Press Office: Jo Anthony (UK): +44 (0) 7582 726 634
janthony@cochrane.org or pressoffice@cochrane.org
Doctors and patients making decisions together could reduce the
number of antibiotics prescribed for acute respiratory infections
A new Cochrane Review published today shows that when doctors and patients are
encouraged to discuss the need for prescribing antibiotics for acute respiratory
infections jointly, fewer are prescribed. This may be useful in the fight against
antibiotic resistance.
Shared decision making between clinicians and patients is an important part of
patient-centred care. The ideal process combines the best available evidence about
the benefits and harms of an intervention with the patient’s values and preferences,
as part of a discussion with their general practitioner (GP) or health professional. As
a result, the health professional and patient jointly make the decision about what to
do next.
Acute respiratory infections such as an acute cough, middle ear infection, or sore
throat are among the most common reasons to see a doctor, especially during the
winter. Health professionals commonly prescribe antibiotics for these conditions,
despite good evidence that they provide little benefit.
There is concern about the continued over-use of antibiotics, which has led to some
bacteria becoming resistant to their effects. This means that antibiotics will no longer
work to treat conditions for which they used to be effective. This development is
widely considered a major threat to global health.
A team of Cochrane researchers looked at 10 randomized trials which involved more
than 1,100 primary care doctors and around 492,000 patients, mainly from the UK
and Europe. The studies tested interventions such as training GPs in specific
communication skills to establish patients’ concerns and beliefs about the need for
antibiotics, their harms and benefits, and to agree a management plan with patients.
Some studies also tested the provision of written information about antibiotics to
patients, and encouraging discussion with doctors about whether they are
necessary.
The review found that the numbers of antibiotic prescriptions for acute respiratory
infections within six weeks of consultation were lower in groups that had received the
training and information, compared with groups that had not. Based on the analysis
of data from eight of the included trials, 47% of patients in the control groups were
given a prescription, compared with 29% in the groups where the GPs or patients
had received training or information. The researchers evaluated the quality of the
evidence for the short-term effects as moderate; the long-term effects are uncertain,
as few trials measured this.
Professor of Clinical Epidemiology Tammy C Hoffmann, from the Centre for
Research in Evidence-Based Practice, Bond University, Australia, says, “The
evidence from this review shows that fewer antibiotics for acute respiratory infections
could be prescribed if more patients and doctors made decisions jointly. It’s
important that health professionals and patients are supported to have quality
conversations about the use of antibiotics so that informed decisions can be made.”
Co-author, Peter Coxeter, also from Bond University, says, “This could be one
relatively simple way in which we reduce the effects of antibiotic resistance, but we
need to find out if this type of training has a longer term effect on resistance.”
Editor in Chief of the Cochrane Library David Tovey said, “This Cochrane Review
addresses one of the most urgent global health challenges we face. Overuse of
antibiotics has major consequences for individual patients and society more
generally. Some clinicians believe that the pressure to prescribe antibiotics comes
from the patients, but this review shows that shared decision making may reduce
usage.”
Access the full study on the Wiley Press Room here. (To access PDFs and embargoed stories
you must be logged in to the Press Room before clicking the link. Request a login here.)
Full citation: Coxeter P, Del Mar CB, McGregor L, Beller EM, Hoffmann TC. Interventions to facilitate
shared decision making to address antibiotic use for acute respiratory infections in primary care.
Cochrane Database of Systematic Reviews 2015, Issue 11. Art. No.: CD010907. DOI:
10.1002/14651858.CD010907.pub2.
URL Upon publication: http://doi.wiley.com/10.1002/14651858.CD010907.pub2
For further information please contact: Jo Anthony, Senior Media and Communications Officer,
Cochrane at M +44(0) 7582 726 634 or janthony@cochrane.org, pressoffice@cochrane.org. Tammy
C Hoffmann, Professor of Clinical Epidemiology, Centre for Research in Evidence-Based Practice
(CREBP) at Bond University, University Drive, Gold Coast, Queensland, 4229, Australia. E-mail:
thoffmann@bond.edu.au or Terri Fellowes, Public Relations Manager, Bond University, Australia at
Phone: +61 7 5595 1116, Mobile: +61 (0) 420 927 941 or E-mail: tfellowe@bond.edu.au.
About Cochrane
Cochrane is a global independent network of researchers, professionals, patients, carers and people
interested in health. Cochrane produces reviews which study all of the best available evidence
generated through research and make it easier to inform decisions about health. These are called
systematic reviews. Cochrane is a not-for profit organisation with collaborators from more than 120
countries working together to produce credible, accessible health information that is free from
commercial sponsorship and other conflicts of interest. Our work is recognised as representing an
international gold standard for high quality, trusted information.
Find out more at http://cochrane.org
Follow us on twitter @cochranecollab
If you are a journalist or member of the press and wish to receive news alerts before their
online publication or if you wish to arrange an interview with an author, please contact the
Cochrane press office: pressoffice@cochrane.org.
About Wiley
Wiley is a global provider of knowledge and knowledge-enabled services that improve outcomes in
areas of research, professional practice and education. Through the Research segment, the
Company provides digital and print scientific, technical, medical, and scholarly journals, reference
works, books, database services, and advertising. The Professional Development segment provides
digital and print books, online assessment and training services, and test prep and certification. In
Education, Wiley provides education solutions including online program management services for
higher education institutions and course management tools for instructors and students, as well as
print and digital content. The Company's website can be accessed at www.wiley.com.
If you would like to request complimentary media access to the contents of The Cochrane
Library, please email sciencenewsroom@wiley.com.