Peer pressure may curb unnecessary antibiotic prescriptions

Pharmacist medication

In the struggle to reduce overprescription of antibiotics, peer pressure yields better results than other forms of prodding and persuasion, according to The Wall Street Journal.

A study published in the Journal of the American Medical Association tested the results of three different interventions designed to change physicians’ prescribing behavior for cases of acute respiratory-tract infection. Doctors presented with a range of alternative interventions failed to change their prescribing habits. Those prompted to explain their reasoning for prescribing the drugs did so significantly less, but the greatest reduction came when researchers sent providers emails comparing their antibiotic prescribing habits to their top-performing peers, dropping the rate of unnecessary prescriptions from 20 percent to 4 percent.

Inappropriate prescriptions of antibiotics have been estimated to be as high as 30 percent of the overall scripts written, which creates public health issues by increasing the prevalence of antibiotic-resistant bacteria and raising overall healthcare costs, according to the article. Jeffrey Linder, M.D., one of the study’s authors, suggested the approach was effective because it appealed to doctors’ sense of competitiveness by suggesting their behaviors indicated they were not “top performers.”

In situations where the need for antibiotics can be murky, a peer comparison can serve as a useful “reality check,” Michael Healy, M.D., a physician with Brigham and Women’s primary-care group, told the newspaper. He says doctors considering an unnecessary prescription often “may be erring on what they perceive to be the side of caution, when really erring on the side of caution would be not prescribing antibiotics.”

Peer comparison seemed to be a key factor in overcoming physicians’ general resistance to data-generated prodding. “We expected and got a lot of pushback,” says Linder, “but it was the most effective intervention.”

Linder also sees potential for a similar approach in curbing the prescription rates of opioid painkillers.

- here’s the story
- read the study abstract