Peer pressure may be the secret to curb inappropriate prescribing of antibiotics

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Practices need to maintain interventions to curb inappropriate antibiotic prescribing. (Getty)

Behavioral interventions to keep doctors from inappropriately prescribing antibiotics work, but practices need to keep up their efforts to have a long-term impact.

A study of 47 primary care practices in Boston and Los Angeles found that two of three interventions designed to reduce inappropriate antibiotic prescribing were highly effective in the short term, but the results declined when the interventions ended. The research, published in JAMA, suggests that practices need to continue such efforts to make a lasting change in doctors’ prescribing habits.

"These findings suggest that institutions exploring behavioral interventions to influence clinician decision-making should consider applying them long-term," the researchers wrote. Many of the 248 primary care clinicians studied didn’t maintain better prescribing habits a year after the interventions ended.

Two interventions were effective for changing doctors' prescribing of antibiotics for acute respiratory infections. An intervention that used the electronic health record to ask physicians to justify their reason for prescribing an antibiotic helped reduce inappropriate prescribing. Also, an intervention that sent monthly emails to doctors comparing their prescribing practices to those of peers with the lowest rates resulted in reductions.

In fact, peer comparison had the longest effect, as researchers said that may have led clinicians to make judicious prescribing practices part of their professional self-image.

Inappropriate antibiotic prescribing contributes to antibiotic resistance and leads to adverse events, which are more common than many doctors realize, according to a study published earlier this year.