Development and efficacy of a clinician‐targeted refresher course for treating nonpneumonia respiratory tract infections. (21st June 2018)

• Record Type: Journal Article
• Authors: Yamamoto, Shungo; Gu, Yoshiaki; Fujitomo, Yumiko; Kanai, Nobuyuki; Yamahata, Yoshihiro; Saito, Hiroyuki; Hashimoto, Tadayuki; Ohmagari, Norio
• Is Part Of: Journal of general and family medicine. Volume 19:Number 4(2018)
• Page Start: 127
• Page End: 132
• Publication Date: 2018-06-21
• Subjects: antimicrobial resistance -- family medicine -- illness scripts -- interactive communication skills training -- respiratory tract infections -- role‐play; Primary care (Medicine) -- Periodicals; Family medicine -- Periodicals; Family Practice; Primary Health Care; Japan; Periodicals; 610
• DOI: 10.1002/jgf2.183
• Languages: English
• ISSNs: 2189-7948

Abstract

Abstract: Background: In 2017, the Japanese government published an evidence‐based manual describing the appropriate use of antibiotics in outpatient settings to tackle the problem of antimicrobial resistance. To fill the evidence‐practice gap, we developed a clinician‐targeted course aimed at improving clinician skills in the daily clinical practice of treating acute respiratory tract infections (RTIs) based on the manual. The aim of this study was to evaluate the efficacy of the course. Methods: This course consisted of lectures using illness scripts and checklists, as well as interactive communication skills training using role‐playing. We performed a vignette‐based evaluation of the changes in the knowledge and attitudes of the course participants toward prescribing antibiotics for nonpneumonia RTIs, using pre‐ and postcourse questionnaires. The questionnaires also included course feedback via the use of a 5‐point Likert scale. Results: Thirty‐eight clinicians were included in the analyses, and 90% of these participants had graduated ≥20 years ago. We found statistically significant reductions in the intention to prescribe antibiotics for four of the six nonpneumonia RTI vignettes: acute bronchitis (−47.2%; 95% confidence interval [CI] −66.3 to −28.1%), common cold (−16.2%; 95% CI −30.8 to −1.6%), acute pharyngitis (−27.0%; 95% CI −49.0 to −5.0%), and acute rhinosinusitis (−33.3%; 95% CI −53.3 to −13.3%). The course seemed to be satisfactory for experienced doctors who were the relevant target population of such a workshop. Conclusions: The refresher course was helpful for reducing the participants' intensions to prescribe antibiotics for nonpneumonia RTIs. Abstract : We developed a clinician‐targeted refresher course for the practice of treating nonpneumonia RTIs, which consisted of lectures using illness scripts and checklists, and interactive communication skills training using a role‐playing. After the course, we found significant reductions in the proportions of the participants' attitudes toward prescribing antibiotics for nonpneumonia RTIs.