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Table 1 Antibiotic prescription rate of trials with baseline data and post-intervention measurements

From: Reduction of antibiotic prescriptions for acute respiratory tract infections in primary care: a systematic review

Study Absolute number of prescribed Abx (in %/95% CI/p value) for IG and GC; adjusted OR; RR Difference in Abx prescription rates between corresponding study arms (in %)/difference in differences for Abx prescriptions between IG and CG Odds ratio for Abx prescriptions (95% CI, p value) Absolute reduction of Abx prescriptions in the corresponding study arm (in %)
Bjerrum et al. 2006
Spain
T0:
IG: n.s. (36%/29–44%/n.s.)
CG: not performed
T1:
IG: n.s. (24%/20–29%/n.s.)
CG: n.s. (32%/27–38%/n.s.)
T0:
n.s.
T1:
Δ (IG − CG) = − 12%
Difference in differences:
n.s.
T0:
n.s.
T1:
IG and CG: 0.67
IG:
Δ (T1 − T0) = − 12%
CG:
n.s.
Altiner et al. 2007
Germany
T0:
IG: n.s. (36.4%/n.s./n.s.)
CG: n.s. (54.7%/n.s./n.s.)
T1:
IG: n.s. (29.4%/n.s./n.s.)
Adjusted OR for IG: 0.58 (95% CI 0.43–0.78, p < 0.001)
CG: n.s. (59.4%/n.s./n.s.)
Adjusted OR for CG: 1.52 (95% CI 1.19–1.95, p = 0.001)
T2:
IG: n.s. (36.7%/n.s./n.s.)
Adjusted OR for IG: 0.72 (95% CI 0.54–0.97, p = 0.028)
CG: n.s. (64.8%/n.s./n.s.)
Adjusted OR for CG: 1.31 (95% CI 1.01–1.71, p = 0.044)
T0:
Δ (IG − CG) = − 18.3%
T1:
Δ (IG − CG) = − 30%
T2:
Δ (IG − CG) = − 28.1%
Difference in differences:
IG for T2: − 9.8%
T0:
IG and CG: 0.47
T1:
IG and CG: 0.28
T2:
IG and CG: 0.31
IG:
Δ (T1 − T0) = − 7%
Δ (T2 − T1) = − 7.3%
Δ (T2 − T0) = + 0.3%
CG:
Δ (T1 − T0) = + 4.7%
Δ (T2 − T1) = + 5.4%
Δ (T2 − T0) = + 10.1%
Gonzales et al. 2013
USA
T0:
IG 1: n.s. (80%/n.s./n.s.)
IG 2: n.s. (74%/n.s./n.s.)
CG: n.s. (72.5%/n.s./n.s.)
T1:
IG 1: n.s. (68.3%/n.s./n.s.)
IG 2: n.s. (60.7%/n.s./n.s.)
CG: n.s. (74.3%/n.s./n.s.)
T0: Δ (IG 2 − IG 1) = − 6%
Δ (IG 1 − CG) = + 7.5%
Δ (IG 2 − CG) = + 1.5%
T1:
Δ (IG 2 − IG 1) = − 7.6% (p = 0.67)
Δ (IG 1 − CG) = − 6% (p = 0.003)
Δ (IG 2 − CG) = − 13.6% (p = 0.01)
Difference in differences:
For IG 1: − 13.5%
For IG 2: − 15.1%
T0:
IG 1 and IG 2: 1.4
IG 1 and CG: 1.52
IG 2 and CG: 1.08
T1:
IG 1 and IG 2: 1.39
IG 1 and CG: 0.75
IG 2 and CG: 0.53
I 1:
Δ (T1 − T0) = − 11.7%
I 2:
Δ (T1 − T0) = − 13.3%
C:
Δ (T1 − T0) = + 1.8%
Gjelstad et al. 2013*
Norway
T0:
IG: n.s. (34.3%/31.8–36.9/n.s.)
CG: n.s. (35.2%/CI 32.8–37.7/n.s.)
T1:
IG: n.s. (32.8%/30.3–35.3/n.s.)
CG: n.s. (36.9%/34.2–39.7/n.s.)
T0:
Δ (IG − CG) = − 0.9%
T1:
Δ (IG − CG) = − 4.1%
Difference in differences:
IG: + 0.2%
T0:
IG and CG: 0.96
T1:
IG and CG: 0.83
IG:
Δ (T1 − T0) = − 1.52%
(95% CI − 2.85 to − 0.18, p = 0.027)
CG:
Δ (T1 − T0) = + 1.70
(95% CI 0.69–2.72, p = 0.002)
Andreeva et al. 2014
Russia
Subgroup of 13 physicians:
T0:
IG: 28/47 (59%/n.s./n.s.)
CG: 21/34 (62%/n.s./n.s.)
T1:
IG: 30/81 (37%/n.s./n.s.) CG: 44/62 (71%/n.s./n.s.)
T1 for all 18 GPs:
IG: n.s. (37.6%/n.s./n.s.)
CG: n.s. (58.9%/n.s./n.s.)
T2 for all 18 GPs:
IG: n.s. (40.6%/n.s./n.s.)
CG: n.s. (71.8%/n.s./n.s.)
T0:
Δ (IG − CG) = − 3%
T1 for subgroup of 13 GPs who also participated in baseline study:
Δ (IG − CG) = − 34%
T1 for all 18 GPs:
Δ (IG − CG) = − 21.3% (p = 0.006)
T2 for all 18 GPs:
Δ (IG − CG) = − 31.2% (p = 0.0001)
Difference in differences:
n.s.
T0 only for 13 GPs:
IG and CG: 0.91
T1 for subgroup of 13 GPs who also participated in baseline study:
IG and CG: 0.24
T1 for all 18 GPs:
IG and CG: 0.42
T2 for all 18 GPs:
IG and CG: 0.27
IG (subgroup of 13 GPs):
Δ (T1 − T0) = − 22%
CG (subgroup of 13 GPs):
Δ (T1 − T0) = + 9%
IG (all GPs):
Δ (T2 − T1) = + 4%
CG (all GPs):
Δ (T2 − T1) = + 12.9%
Gulliford et al. 2014
UK
T0:
IG: n.s. (53%/n.s./n.s.)
CG: n.s. (52%/n.s./n.s.)
T1:
IG: n.s. (52%/n.s./n.s.)
CG: n.s. (52%/n.s./n.s.)
T0:
Δ (IG − CG) = + 1%
T1:
Δ (IG − CG) = 0%
Adjusted mean difference (adjusted for pre-intervention value, as well as mean age and proportion of women at each practice): − 1.85% (95% CI 0.10–3.59%; p = 0.038)
Difference in differences:
IG: − 1%
T0:
IG and CG: 1.04
T1:
IG and CG: 1.00
IG:
Δ (T1 − T0) = − 1%
CG:
Δ (T1 − T0) = 0%
Little et al. 2013
Belgium, Spain, Wales, Great Britain, Poland, Netherlands
T0: 3742/6771 (55.3%/n.s./n.s.)
T1:
Abx prescription rates regarding study arms:
CG: 508/870 (58%/n.s./n.s.), OR = 1.00
Internet-based training for CRP-POCT: 368/1062 (35%/n.s./n.s.)
OR = 0.54 (95% CI 0.40–0.68; p < 0.001)
Internet-based CST: 476/1170 (41%/n.s./n.s.)
OR = 0.69 (95% CI 0.54–0.85; p < 0.001)
Internet-based CST + CRP-POCT: 366/1162 (32%/n.s./n.s.)
OR = 0.46 (95% CI 0.35–0.60; p < 0.001)
Abx prescription rates regarding factorial groups:
Cumulative non-CRP-training group: 984/2040 (48%/n.s./n.s.)
Cumulative CRP-training group: 734/2224 (33%/n.s./n.s.)
Cumulative non-CST group: 876/1932 (45%/n.s./n.s.)
Cumulative CST group: 842/2332 (36%/n.s./n.s.)
T1:
Δ (cumulative CRP group − cumulative non-CRP group): − 15%
Δ (cumulative CST group − cumulative non-CST group): − 9%
Difference in differences:
n.s.
T0: n.s.
T1:
Cumulative CRP-training group and cumulative non-CRP training group: 0.54 (95% CI 0.42–0.69, p < 0.0001)
Cumulative CRP-training group and cumulative communication training group: 0.88
Cumulative communication training group and cumulative non-communication training group: 0.69 (95% CI 0.54–0.87, p < 0.0001)
CG:
Δ (T1T0) = + 3%
Internet-based training for CRP-POCT:
Δ (T1 − T0) = − 20%
Internet-based communication training:
Δ (T1 − T0) = − 14%
Internet-based communication training + CRP-POCT:
Δ (T1 − T0) = − 23%
Cumulative non-CRP-training group:
Δ (T1 − T0) = − 7%
Cumulative CRP-training group:
Δ (T1 − T0) = − 22%
Cumulative no-CST group:
Δ (T1 − T0) = − 10%
Cumulative CST group:
Δ (T1 − T0) = − 19%
Meeker et al. 2016
USA
T0 for each study group:
IG 1: 1057/2132 (49.6%/47.5–51.7/n.s.)
IG 2: 497/1491 (33.3%/30.9–37.7/n.s.)
IG 3: 433/1236 (35.0%/32.4–37.7/n.s.)
IG 1 + 2: 702/1977 (35.5%/33.4–37.6/n.s.)
IG 1 + 3: 368/1511 (24.4%/22.2–26.5/n.s.)
IG 2 + 3: 782/2362 (33.1%/31.2–35.0/n.s.)
IG 1 + 2 + 3: 558/2178 (25.6%/23.8–37.5/n.s.)
CG: 692/1866 (37.1%/34.9–39.3/n.s.)
T1 for each study group:
IG 1: 722/2388 (30.2%/28.4–32.1/n.s.)
IG 2: 324/1979 (16.4%/14.7–18.0/n.s.)
IG 3: 311/1620 (19.2%/17.3–21.1/n.s.)
IG 1 + 2: 341/2131 (16.0%/14.5–17.6/n.s.)
IG 1 + 3: 139/2014 (6.9%/5.8–8.0/n.s.)
IG 2 + 3: 340/2240 (15.2%/13.7–16.7/n.s.)
IG 1 + 2 + 3: 249/2492 (10.0%/8.8–11.2/n.s.)
CG: 502/2095 (24.0%/22.1–25.8/n.s.)
T0:
Δ (IG 1 − CG): + 12.5%
Δ (IG 2 − CG): − 3.8%
Δ (IG 3 − CG): − 2.1%
Δ (IG 1 − IG 2): + 16.3%
Δ (IG 1 − IG 3): + 14.6%
Δ (IG 2 − IG 3): − 1.7%
T1:
Δ (IG 1 − CG): + 6.2%
Δ (IG 2 − CG): − 7.6%
Δ (IG 3 − CG): − 4.8%
Δ (IG 1 − IG 2): + 13.8%
Δ (IG 1 − IG 3): + 11%
Δ (IG 2 − IG 3): − 2.8%
Difference in differences:
IG 1: − 6.3%
IG 2: − 3.8%
IG 3: − 2.7%
IG 1 + 2: − 6.4%
IG 1 + 3: − 4.4%
IG 2 + 3: − 4.8%
IG 1 + 2 + 3: − 2.5%
T0:
IG 1 and CG: 1.67
IG 2 and CG: 0.85
IG 3 and CG: 0.91
IG 1 and IG2: 1.97
IG 1 and IG 3: 1.83
IG 2 and IG 3: 0.93
T1:
IG 1 and CG: 1.37
IG 2 and CG: 0.62
IG 3 and CG: 0.75
IG 1 and IG 2: 2.21
IG 1 and IG 3: 1.82
IG 2 and IG 3: 0.83
IG 1:
Δ (T1 − T0) = − 19.4%
IG 2:
Δ (T1 − T0) = − 16.9%
IG 3:
Δ (T1 − T0) = − 15.8%
IG 1 + 2:
Δ (T1 − T0) = − 19.5%
IG 1 + 3:
Δ (T1 − T0) = − 17.5%
IG 2 + 3:
Δ (T1 − T0) = − 17.9%
IG 1 + 2 + 3:
Δ (T1 − T0) = − 15.6%
CG:
Δ (T1 − T0) = − 13.1%
Adjusted analysis (hierarchical regression model) for factorial study groups:
CG:
Δ (T1 − T0) = − 11.0%
IG 1:
Δ (T1 − T0) = − 16%
IG 2:
Δ (T1 − T0) = − 18.1%
IG 3:
Δ (T1 − T0) = − 16.3%
  1. n.s. not specified, IG intervention group, CG control group, RR relative risk, OR odds ratio, POCT point-of-care testing, CRP C-reactive protein, CDSS clinical decision support system, 95% CI 95% confidence interval
  2. *Unpublished data for patient sample ≥ 13 years, provided by Gjelstad et al.