Eilermann, Kerstin, Halstenberg, Katrin, Kuntz, Ludwig, Martakis, Kyriakos ORCID: 0000-0003-3982-0914, Roth, Bernhard and Wiesen, Daniel (2019). The Effect of Expert Feedback on Antibiotic Prescribing in Pediatrics: Experimental Evidence. Med. Decis. Mak., 39 (7). S. 781 - 796. THOUSAND OAKS: SAGE PUBLICATIONS INC. ISSN 1552-681X

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Abstract

Background. Inappropriate prescribing of antibiotics, which is common in pediatric care, is a key driver of antimicrobial resistance. To mitigate the development of resistance, antibiotic stewardship programs often suggest the inclusion of feedback targeted at individual providers. Empirically, however, it is not well understood how feedback affects individual physicians' antibiotic prescribing decisions. Also, the question of how physicians' characteristics, such as clinical experience, relate to antibiotic prescribing decisions and to responses to feedback is largely unexplored. Objective. To analyze the causal effect of descriptive expert feedback (and individual characteristics) on physicians' antibiotic prescribing decisions in pediatrics. Design. We employed a randomized, controlled framed field experiment, in which German pediatricians (n=73) decided on the length of first-line antibiotic treatment for routine pediatric cases. In the intervention group (n=39), pediatricians received descriptive feedback in form of an expert benchmark, which allowed them to compare their own prescribing decisions with expert recommendations. The recommendations were elicited in a survey of pediatric department directors (n=20), who stated the length of antibiotic therapies they would choose for the routine cases. Pediatricians' characteristics were elicited in a comprehensive questionnaire. Results. Providing pediatricians with expert feedback significantly reduced the length of antibiotic therapies by 10% on average. Also, the deviation of pediatricians' decisions from experts' recommendations significantly decreased. Antibiotic therapy decisions were significantly related to pediatricians' clinical experience, risk attitudes, and personality traits. The effect of feedback was significantly associated with physicians' experience. Conclusion. Our results indicate that descriptive expert feedback can be an effective means to guide pediatricians, especially those who are inexperienced, toward more appropriate antibiotic prescribing. Therefore, it seems to be suitable for inclusion in antibiotic stewardship programs.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Eilermann, KerstinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Halstenberg, KatrinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuntz, LudwigUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Martakis, KyriakosUNSPECIFIEDorcid.org/0000-0003-3982-0914UNSPECIFIED
Roth, BernhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wiesen, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-144183
DOI: 10.1177/0272989X19866699
Journal or Publication Title: Med. Decis. Mak.
Volume: 39
Number: 7
Page Range: S. 781 - 796
Date: 2019
Publisher: SAGE PUBLICATIONS INC
Place of Publication: THOUSAND OAKS
ISSN: 1552-681X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
RESPIRATORY-TRACT INFECTIONS; PHYSICIANS RISK ATTITUDES; PRIMARY-CARE; ANTIMICROBIAL STEWARDSHIP; INFORMATION DISTORTION; DECISION-MAKING; PERSONALITY; RESISTANCE; INTERVENTION; DETERMINANTSMultiple languages
Health Care Sciences & Services; Health Policy & Services; Medical InformaticsMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/14418

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