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Patient information leaflets to reduce antibiotic use and reconsultation rates in general practice: a systematic review.
de Bont, Eefje G P M; Alink, Marleen; Falkenberg, Famke C J; Dinant, Geert-Jan; Cals, Jochen W L.
Afiliação
  • de Bont EG; Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
  • Alink M; Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
  • Falkenberg FC; Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
  • Dinant GJ; Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
  • Cals JW; Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
BMJ Open ; 5(6): e007612, 2015 Jun 03.
Article em En | MEDLINE | ID: mdl-26041493
OBJECTIVE: Patients' knowledge and expectations may influence prescription of antibiotics. Therefore, providing evidence-based information on cause of symptoms, self-management and treatment is essential. However, providing information during consultations is challenging. Patient information leaflets could facilitate consultations by increasing patients' knowledge, decrease unnecessary prescribing of antibiotics and decrease reconsultations for similar illnesses. Our objective was to systematically review effectiveness of information leaflets used for informing patients about common infections during consultations in general practice. DESIGN, SETTING AND PARTICIPANTS: We systematically searched PubMed/MEDLINE and EMBASE for studies evaluating information leaflets on common infections in general practice. Two reviewers extracted data and assessed article quality. PRIMARY AND SECONDARY OUTCOME MEASURES: Antibiotic use and reconsultation rates. RESULTS: Of 2512 unique records, eight studies were eligible (7 randomised, controlled trials, 1 non-randomised study) accounting for 3407 patients. Study quality varied from reasonable to good. Five studies investigated effects of leaflets during consultations for respiratory tract infections; one concerned conjunctivitis, one urinary tract infections and one gastroenteritis and tonsillitis. Three of four studies presented data on antibiotic use and showed significant reductions of prescriptions in leaflet groups with a relative risk (RR) varying from 0.53 (0.40 to 0.69) to 0.96 (0.83 to 1.11). Effects on reconsultation varied widely. One large study showed lower reconsultation rates (RR 0.70 (0.53 to 0.91), two studies showed no effect, and one study showed increased reconsultation rates (RR 1.53 (1.03 to 2.27)). Studies were too heterogenic to perform a meta-analysis. CONCLUSIONS: Patient information leaflets during general practitioners consultations for common infections are promising tools to reduce antibiotic prescriptions. Results on reconsultation rates for similar symptoms vary, with a tendency toward fewer reconsultations when patients are provided with a leaflet. Use of information leaflets in cases of common infections should be encouraged. Their contributing role in multifaceted interventions targeting management of common infections in primary care needs to further exploration.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Folhetos / Encaminhamento e Consulta / Educação de Pacientes como Assunto / Prescrição Inadequada / Medicina Geral / Infecções / Antibacterianos Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Systematic_reviews Limite: Humans Idioma: En Revista: BMJ Open Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Holanda

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Folhetos / Encaminhamento e Consulta / Educação de Pacientes como Assunto / Prescrição Inadequada / Medicina Geral / Infecções / Antibacterianos Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Systematic_reviews Limite: Humans Idioma: En Revista: BMJ Open Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Holanda