Table 2.

Effects of A&F interventions on prescribing.

StudyOutcome measure
(Total number of prescribing outcomes reported)
Intended direction of changeEffect of interventionFollow-up (& losses to follow-up—LTF)
Lim, 201840Prescriptions with errors
(1)
Tx*: 2,641/7,280 prescriptions (36.3%)
Cx: 2,102/3,920 prescriptions (53.6%)
RR: 0.68 (0.65–0.71)
4 months
Tx: No clinics LTF; Cx: No clinics LTF
Trietsch, 201731Mean no. of DDD antibiotic prescriptions for UTI/6 months/1,000 patients
(19)
Tx: 47.3 (36.5)/86 GPs
Cx: 59.7 (48.7)/122 GPs
SMD: −0.28 (−0.56, −0.00)
9 months
Tx topic group A (Cx topic group B): 1 LQIC (10 GPs) LTF
Cx topic group A (Tx topic group B): 2 LQICs (17 GPs) LTF
Vervloet 201632Mean no. antibiotic prescriptions for RTI/year/1,000 patients
(1)
Tx: 155 (51.7)/59,483 patients
Cx: 160 (35.8)/94,767 patients
SMD −0.11 (−0.12, −0.10)
12 months
Tx: None LTF; Cx: None LTF
Clyne, 201537Potentially inappropriate prescriptions
(12)
Tx: 52/96 patients (52.5%)
Cx: 75/94 patients (77.3%)
RR: 0.68 (0.55–0.84)
5 months
Tx: 3 patients LTF; Cx: 3 patients LTF
Magrini (TEA), 201433Appropriate prescriptions for osteoporosis or prostatic hyperplasia
(4)
Results data not available6 months
Tx therapeutic area A (Cx therapeutic area B): 1 PCG (56 GPs) LTF
Cx therapeutic area A (Tx therapeutic area B): 76 GPs LTF
Magrini (SIDRO), 201433Prescriptions for barnidipine or prulifloxacin
(2)
Results data not available6 months
Tx drug A (Cx drug B): 3 PCGs (92 GPs) LTF
Cx drug A (Tx drug B): 79 GPs LTF
Avery, 201234At least 1 prescription problem/at risk of at least 1 prescription problem
(11)
Tx: 553/24,073 patients (2.3%)
Cx: 752/26,329 patients (2.9%)
RR: 0.80 (0.72–0.90)
6 months
Tx: No general practices LTF; Cx: No general practices LTF
Pape, 201139Prescriptions for lipid-lowering medication
(1)
Tx: 471/2,047 patients (23.0%)
Cx: 1,819/4,916 patients (37.0%)
RR: 0.62 (0.57–0.68)
24 months
Tx: No primary care clinic LTF; Cx: No primary care clinic TF
Bregnhoj, 200935Medications Appropriate Index score
(1)
Tx*: 6/49 GPs
Cx: 10.1/64 GPs
Insufficient data for SMD calculation
12 months
Tx: 8 patients LTF; Cx: 8 patients LTF
Fretheim, 200636Prescriptions for thiazide
(1)
Tx: 706/854 patients (83.0%)
Cx: 683/768 patients (89.0%)
RR: 0.93 (0.89–0.97)
12 months
Tx: No general practices LTF; Cx: No general practices LTF
Crotty, 200438Prescriptions for any psychotropic medication
(3)
Tx: 266/381 patients (69.9%)
Cx: 227/334 patients (68.0%)
RR: 1.03 (0.93–1.13)
7 months
Tx: No residential facilities LTF; Cx: No residential facilities LTF
StudyOutcome measure
(Total number of prescribing outcomes reported)
Intended direction of changeEffect of interventionFollow-up (& losses to follow-up—LTF)
Lim, 201840Prescriptions with errors
(1)
Tx*: 2,641/7,280 prescriptions (36.3%)
Cx: 2,102/3,920 prescriptions (53.6%)
RR: 0.68 (0.65–0.71)
4 months
Tx: No clinics LTF; Cx: No clinics LTF
Trietsch, 201731Mean no. of DDD antibiotic prescriptions for UTI/6 months/1,000 patients
(19)
Tx: 47.3 (36.5)/86 GPs
Cx: 59.7 (48.7)/122 GPs
SMD: −0.28 (−0.56, −0.00)
9 months
Tx topic group A (Cx topic group B): 1 LQIC (10 GPs) LTF
Cx topic group A (Tx topic group B): 2 LQICs (17 GPs) LTF
Vervloet 201632Mean no. antibiotic prescriptions for RTI/year/1,000 patients
(1)
Tx: 155 (51.7)/59,483 patients
Cx: 160 (35.8)/94,767 patients
SMD −0.11 (−0.12, −0.10)
12 months
Tx: None LTF; Cx: None LTF
Clyne, 201537Potentially inappropriate prescriptions
(12)
Tx: 52/96 patients (52.5%)
Cx: 75/94 patients (77.3%)
RR: 0.68 (0.55–0.84)
5 months
Tx: 3 patients LTF; Cx: 3 patients LTF
Magrini (TEA), 201433Appropriate prescriptions for osteoporosis or prostatic hyperplasia
(4)
Results data not available6 months
Tx therapeutic area A (Cx therapeutic area B): 1 PCG (56 GPs) LTF
Cx therapeutic area A (Tx therapeutic area B): 76 GPs LTF
Magrini (SIDRO), 201433Prescriptions for barnidipine or prulifloxacin
(2)
Results data not available6 months
Tx drug A (Cx drug B): 3 PCGs (92 GPs) LTF
Cx drug A (Tx drug B): 79 GPs LTF
Avery, 201234At least 1 prescription problem/at risk of at least 1 prescription problem
(11)
Tx: 553/24,073 patients (2.3%)
Cx: 752/26,329 patients (2.9%)
RR: 0.80 (0.72–0.90)
6 months
Tx: No general practices LTF; Cx: No general practices LTF
Pape, 201139Prescriptions for lipid-lowering medication
(1)
Tx: 471/2,047 patients (23.0%)
Cx: 1,819/4,916 patients (37.0%)
RR: 0.62 (0.57–0.68)
24 months
Tx: No primary care clinic LTF; Cx: No primary care clinic TF
Bregnhoj, 200935Medications Appropriate Index score
(1)
Tx*: 6/49 GPs
Cx: 10.1/64 GPs
Insufficient data for SMD calculation
12 months
Tx: 8 patients LTF; Cx: 8 patients LTF
Fretheim, 200636Prescriptions for thiazide
(1)
Tx: 706/854 patients (83.0%)
Cx: 683/768 patients (89.0%)
RR: 0.93 (0.89–0.97)
12 months
Tx: No general practices LTF; Cx: No general practices LTF
Crotty, 200438Prescriptions for any psychotropic medication
(3)
Tx: 266/381 patients (69.9%)
Cx: 227/334 patients (68.0%)
RR: 1.03 (0.93–1.13)
7 months
Tx: No residential facilities LTF; Cx: No residential facilities LTF

*3-arm study—results shown for 2 arms only (full A&F intervention vs. control). DDD, defined daily dose; LTF, lost to follow-up; LQIC, Local Quality Improvement Collaborative; SMD, standardized mean difference; Tx, treatment (intervention); Cx, control; UTI, urinary tract infection; RTI, respiratory tract infection.

Table 2.

Effects of A&F interventions on prescribing.

StudyOutcome measure
(Total number of prescribing outcomes reported)
Intended direction of changeEffect of interventionFollow-up (& losses to follow-up—LTF)
Lim, 201840Prescriptions with errors
(1)
Tx*: 2,641/7,280 prescriptions (36.3%)
Cx: 2,102/3,920 prescriptions (53.6%)
RR: 0.68 (0.65–0.71)
4 months
Tx: No clinics LTF; Cx: No clinics LTF
Trietsch, 201731Mean no. of DDD antibiotic prescriptions for UTI/6 months/1,000 patients
(19)
Tx: 47.3 (36.5)/86 GPs
Cx: 59.7 (48.7)/122 GPs
SMD: −0.28 (−0.56, −0.00)
9 months
Tx topic group A (Cx topic group B): 1 LQIC (10 GPs) LTF
Cx topic group A (Tx topic group B): 2 LQICs (17 GPs) LTF
Vervloet 201632Mean no. antibiotic prescriptions for RTI/year/1,000 patients
(1)
Tx: 155 (51.7)/59,483 patients
Cx: 160 (35.8)/94,767 patients
SMD −0.11 (−0.12, −0.10)
12 months
Tx: None LTF; Cx: None LTF
Clyne, 201537Potentially inappropriate prescriptions
(12)
Tx: 52/96 patients (52.5%)
Cx: 75/94 patients (77.3%)
RR: 0.68 (0.55–0.84)
5 months
Tx: 3 patients LTF; Cx: 3 patients LTF
Magrini (TEA), 201433Appropriate prescriptions for osteoporosis or prostatic hyperplasia
(4)
Results data not available6 months
Tx therapeutic area A (Cx therapeutic area B): 1 PCG (56 GPs) LTF
Cx therapeutic area A (Tx therapeutic area B): 76 GPs LTF
Magrini (SIDRO), 201433Prescriptions for barnidipine or prulifloxacin
(2)
Results data not available6 months
Tx drug A (Cx drug B): 3 PCGs (92 GPs) LTF
Cx drug A (Tx drug B): 79 GPs LTF
Avery, 201234At least 1 prescription problem/at risk of at least 1 prescription problem
(11)
Tx: 553/24,073 patients (2.3%)
Cx: 752/26,329 patients (2.9%)
RR: 0.80 (0.72–0.90)
6 months
Tx: No general practices LTF; Cx: No general practices LTF
Pape, 201139Prescriptions for lipid-lowering medication
(1)
Tx: 471/2,047 patients (23.0%)
Cx: 1,819/4,916 patients (37.0%)
RR: 0.62 (0.57–0.68)
24 months
Tx: No primary care clinic LTF; Cx: No primary care clinic TF
Bregnhoj, 200935Medications Appropriate Index score
(1)
Tx*: 6/49 GPs
Cx: 10.1/64 GPs
Insufficient data for SMD calculation
12 months
Tx: 8 patients LTF; Cx: 8 patients LTF
Fretheim, 200636Prescriptions for thiazide
(1)
Tx: 706/854 patients (83.0%)
Cx: 683/768 patients (89.0%)
RR: 0.93 (0.89–0.97)
12 months
Tx: No general practices LTF; Cx: No general practices LTF
Crotty, 200438Prescriptions for any psychotropic medication
(3)
Tx: 266/381 patients (69.9%)
Cx: 227/334 patients (68.0%)
RR: 1.03 (0.93–1.13)
7 months
Tx: No residential facilities LTF; Cx: No residential facilities LTF
StudyOutcome measure
(Total number of prescribing outcomes reported)
Intended direction of changeEffect of interventionFollow-up (& losses to follow-up—LTF)
Lim, 201840Prescriptions with errors
(1)
Tx*: 2,641/7,280 prescriptions (36.3%)
Cx: 2,102/3,920 prescriptions (53.6%)
RR: 0.68 (0.65–0.71)
4 months
Tx: No clinics LTF; Cx: No clinics LTF
Trietsch, 201731Mean no. of DDD antibiotic prescriptions for UTI/6 months/1,000 patients
(19)
Tx: 47.3 (36.5)/86 GPs
Cx: 59.7 (48.7)/122 GPs
SMD: −0.28 (−0.56, −0.00)
9 months
Tx topic group A (Cx topic group B): 1 LQIC (10 GPs) LTF
Cx topic group A (Tx topic group B): 2 LQICs (17 GPs) LTF
Vervloet 201632Mean no. antibiotic prescriptions for RTI/year/1,000 patients
(1)
Tx: 155 (51.7)/59,483 patients
Cx: 160 (35.8)/94,767 patients
SMD −0.11 (−0.12, −0.10)
12 months
Tx: None LTF; Cx: None LTF
Clyne, 201537Potentially inappropriate prescriptions
(12)
Tx: 52/96 patients (52.5%)
Cx: 75/94 patients (77.3%)
RR: 0.68 (0.55–0.84)
5 months
Tx: 3 patients LTF; Cx: 3 patients LTF
Magrini (TEA), 201433Appropriate prescriptions for osteoporosis or prostatic hyperplasia
(4)
Results data not available6 months
Tx therapeutic area A (Cx therapeutic area B): 1 PCG (56 GPs) LTF
Cx therapeutic area A (Tx therapeutic area B): 76 GPs LTF
Magrini (SIDRO), 201433Prescriptions for barnidipine or prulifloxacin
(2)
Results data not available6 months
Tx drug A (Cx drug B): 3 PCGs (92 GPs) LTF
Cx drug A (Tx drug B): 79 GPs LTF
Avery, 201234At least 1 prescription problem/at risk of at least 1 prescription problem
(11)
Tx: 553/24,073 patients (2.3%)
Cx: 752/26,329 patients (2.9%)
RR: 0.80 (0.72–0.90)
6 months
Tx: No general practices LTF; Cx: No general practices LTF
Pape, 201139Prescriptions for lipid-lowering medication
(1)
Tx: 471/2,047 patients (23.0%)
Cx: 1,819/4,916 patients (37.0%)
RR: 0.62 (0.57–0.68)
24 months
Tx: No primary care clinic LTF; Cx: No primary care clinic TF
Bregnhoj, 200935Medications Appropriate Index score
(1)
Tx*: 6/49 GPs
Cx: 10.1/64 GPs
Insufficient data for SMD calculation
12 months
Tx: 8 patients LTF; Cx: 8 patients LTF
Fretheim, 200636Prescriptions for thiazide
(1)
Tx: 706/854 patients (83.0%)
Cx: 683/768 patients (89.0%)
RR: 0.93 (0.89–0.97)
12 months
Tx: No general practices LTF; Cx: No general practices LTF
Crotty, 200438Prescriptions for any psychotropic medication
(3)
Tx: 266/381 patients (69.9%)
Cx: 227/334 patients (68.0%)
RR: 1.03 (0.93–1.13)
7 months
Tx: No residential facilities LTF; Cx: No residential facilities LTF

*3-arm study—results shown for 2 arms only (full A&F intervention vs. control). DDD, defined daily dose; LTF, lost to follow-up; LQIC, Local Quality Improvement Collaborative; SMD, standardized mean difference; Tx, treatment (intervention); Cx, control; UTI, urinary tract infection; RTI, respiratory tract infection.

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