Reducing antibiotic usage for acute respiratory infections by increasing guideline adherence including a wait-and-see prescription.

N/A

Rationale: Antibiotic resistance is a growing problem worldwide with considerable costs. It is mainly driven by inappropriate use. It is necessary to look for measures that improve prescribing in antibiotics and that stimulate both health professionals and patients to consider their role in antibiotic use. One method to do so is the so-called wait-and-see prescription (WASP) or delayed prescription. In other countries, such postponed prescription has shown to be an effective means of reducing antibiotic usage for acute respiratory infections, allowing adequate control of symptoms while providing high levels of patient satisfaction.

Objective: To reduce the (irrational) use of antibiotics in upper respiratory tract infections (URTI) in primary care by increasing guideline adherence and thus the use of wait-and-see prescriptions (WASP).

Pretest (t0): Number of antibiotic prescriptions filled at the pharmacy in the 12 months before the first PTAM-meeting;

Posttest (t1): Number of antibiotic prescriptions filled at the pharmacy in the 12 months after the first PTAM-meeting.

Guideline adherence including prescribing wait-and-see prescriptions (WASP) will be subject of a training in 10 pharmacotherapy audit meetings (PTAMs). These 10 PTAMs (and consequently their participants) will be randomly assigned to intervention and control group.

GPs and pharmacists in the intervention-PTAMs will be trained in their PTAM on the principles of WASP and on how to implement this in clinical practice. Special attention will be paid to communication strategies with patients. PTAMs make agreements on how and when to propose a WASP to patients. These agreements are electronically stored and GPs are electronically reminded to these WASP-agreements when they want to prescribe an antibiotic for URTI.