Assessment of the efficacy of a method for providing individual support to general practitioners for prescribing antibiotics: information feedback audit with collegial exchanges

Aim: To determine the results of providing feeding-back information to general practitioners on their antibiotic prescriptions by comparing three methods: providing simple information feedback, information feedback accompanied by a telephone exchange with a physician-advisor, or finally, information feedback accompanied by a collegial exchange in their office with a physician-advisor. Method: We performed a randomized trial comparing 400 general practitioners in three different regions (Auvergne, Limousin, Poitou-Charentes) who prescribed the highest percentage of wide-spectrum antibiotics by dividing them into four groups containing 100 physicians each: control group (1), group receiving just antibiotic prescription profiles (2), group receiving antibiotic prescription profiles plus a telephone exchange with a physician-advisor (3), group receiving antibiotic prescription profiles plus a collegial exchange with a physician-advisor in their office (4). The antibiotic prescription profiles were sent in January 2004 and the exchanges took place in February 2004. We assessed the impact of these actions in March and April 2004 by comparing the four groups according to their average prescription rate of wide-spectrum antibiotics by using variance analysis tests. Results: Three physicians were excluded from the study because they stopped practicing. 20 physicians did not receive the programmed collegial exchange; nonetheless, they were included in the analysis of their respective inclusion group. The percentage of prescriptions for wide-spectrum antibiotics following the three different information feedback actions was not significantly different when group 1 and 2 were compared and when group 3 and 4 were compared. However, there was a significant difference between groups 2 and 3 and between groups 2 and 4 (p < 10 -3 ). Conclusion: An information feedback audit associated with a collegial telephone exchange (just as efficacious as and less expensive than an office exchange) is an efficient method for providing support to general practitioners. It should be further tested over the long-term and in other medical contexts, notably in chronic diseases.