Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Blood tests and better communication skills could cut over-prescribing of antibiotics

26.05.2009
Improving communications skills and the use of a simple blood test could help cut the growing number of inappropriate prescriptions of antibiotics, a joint Cardiff University trial has discovered.

In a major new clinical trial, published in the British Medical Journal, a team of researchers from Cardiff University's School of Medicine together with researchers from the Maastricht University Medical Centre in the Netherlands found those GPs in primary care who underwent training in advanced communications skills and those who made use of a simple blood test prescribed fewer antibiotics for lower respiratory tract infections, which generally do not respond to antibiotics.

Professor Christopher Butler, Head of Department of Primary Care and Public Health at Cardiff University who led the trial, said: "As the problem of bacteria resistant to antibiotic treatment grows, researchers from around the world are seeking ways to improve the quality of antibiotic prescribing. Prescribing antibiotics only when patients will clearly benefit, reduces the pressure that drives antibiotic resistance.

"Conditions like acute bronchitis account for some 80% of all lower respiratory tract infections and despite evidence of little or no benefit from antibiotics, the majority of these patients are still prescribed antibiotics.

"We know that with the many pressures facing GPs, including worry about leaving pneumonia untreated, they often give patients "the benefit of the doubt" and prescribe antibiotics. Our clinical trial therefore sought to evaluate ways antibiotic prescribing could be reduced without adversely affecting patient recovery or satisfaction with care."

The trial evaluated an 'illness focussed' approach, where clinicians seek to better understand the patient's illness experience and communicate more effectively about management, and a 'disease focussed' approach, where clinicians focus on diagnosis, in this case, a simple point-of-care blood test.

The trial randomised 20 general practices in the Netherlands, where 40 GPs managed 431 patients with lower respiratory tract infection.

Dr Kerry Hood, Director of the South East Wales Trials Unit said, "The results showed that 54% of GPs practising according to usual care prescribed antibiotics, whereas 27% of those who had been trained in the advanced communication and 31% of the GPs who used the blood test methods did so. Only 23% of GPs who were trained in the advanced communication skills and who used the blood test prescribed antibiotics."

Professor Butler added, "This international collaboration between primary care researchers from Cardiff and Maastricht has shown that both an 'illness focussed' and a 'disease focussed' approach were effective in reducing antibiotic prescribing, but the two approaches combined give the greatest benefit. We need to both communicate better and improve diagnosis to do the best for our patients and to preserve antibiotic effectiveness for our children.

"Importantly, the results showed that prescribing fewer antibiotics did not mean that patients were unwell for longer. Patient's recovery and satisfaction with care were not compromised by GPs not prescribing their patient antibiotics."

Notes:

1. Jochen W L Cals, Christopher C Butler, Rogier M Hopstaken, Kerenza Hood, Geert-Jan Dinant - Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial was published in the British Medical Journal (BMJ), 2009; 338:b1374

A full copy of the paper is available at: www.bmj.com/cgi/content/full/338/may05_1/b1374?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=cals&searchid=1&FIRSTINDEX

=0&sortspec=date&resourcetype=HWCIT

Additional information is also available at: www.cf.ac.uk/sewtu. The South East Wales Trials Unit (SEWTU) helped design and analyse the trial. The study of common infections is a major theme for SEWTU, and it is implementing several trials and observational studies in this area.

2. School of Medicine

Cardiff University's School of Medicine is a significant contributor to healthcare in Wales, a major provider of professional staff for the National Health Service and an international centre of excellence for research, delivering substantial health benefits locally and internationally. The school's 800 staff include 500 research and academic staff who teach more than 2,000 students, including 1,110 postgraduate students.

The School is based at the Heath Park Campus, a site it shares with the University Hospital of Wales, the third largest university hospital in the UK. The School has an all-Wales role, contributing greatly to promoting, enhancing and protecting the nation's health.

A key partner in this role is the National Health Service (NHS) in Wales, with which the School is linked at all levels. This mutual dependency is illustrated by the teaching of medical undergraduates in more than 150 hospitals located in all of Wales' health authorities. The medical curriculum followed at the School enables students to acquire and apply knowledge, skills, judgement and attitudes appropriate to delivering a high standard of professional care. Around 300 new doctors currently graduate from the School every year and the Welsh Assembly Government has invested substantially in new teaching facilities to increase this number further

3. Cardiff University

Cardiff University is recognised in independent government assessments as one of Britain's leading teaching and research universities and is a member of the Russell Group of the UK's most research intensive universities. Among its academic staff are two Nobel Laureates, including the winner of the 2007 Nobel Prize for Medicine, Professor Sir Martin Evans.

Founded by Royal Charter in 1883, today the University combines impressive modern facilities and a dynamic approach to teaching and research. The University's breadth of expertise in research and research-led teaching encompasses: the humanities; the natural, physical, health, life and social sciences; engineering and technology; preparation for a wide range of professions; and a longstanding commitment to lifelong learning.

Dr. Christopher C. Butler | EurekAlert!
Further information:
http://www.cardiff.ac.uk

More articles from Health and Medicine:

nachricht New malaria analysis method reveals disease severity in minutes
14.08.2017 | University of British Columbia

nachricht New type of blood cells work as indicators of autoimmunity
14.08.2017 | Instituto de Medicina Molecular

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

A Map of the Cell’s Power Station

18.08.2017 | Life Sciences

Engineering team images tiny quasicrystals as they form

18.08.2017 | Physics and Astronomy

Researchers printed graphene-like materials with inkjet

18.08.2017 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>