ObjectiveNPS MedicineWise aims to ensure that medicines are prescribed and used in a manner consistent with current evidence-based best practice. A series of nationwide educational and advertising interventions for general practitioners and consumers were implemented in Australia between 2009 and 2015 with the aim of reducing antibiotic prescriptions for upper respiratory tract infections (URTIs). The work described in this paper quantifies the change in antibiotic dispensing following these interventions.MethodsAntibiotic dispensing data between 2004 and 2015 were obtained from a national claims database. A Bayesian structural time series model was used to forecast a series of antibiotic dispensing volumes expected to have occurred if the interventions had not taken place. These were compared with the volumes that were actually observed to estimate the intervention effect.ResultsOn average, 126,536 fewer antibiotics were dispensed each month since the intervention programs began in 2009 (95% Bayesian credible interval = 71,580–181,490). This change represents a 14% total reduction in dispensed scripts after the series of intervention programs began in 2009.ConclusionsContinual educational intervention programs that emphasise the judicious use of antibiotics may effectively reduce inappropriate prescribing of antibiotics for the treatment of URTIs at a national level.

BackgroundMany patients with back pain do not receive health care in accordance with best practice recommendations. Implementation trials to address this issue have had limited success. Despite the known effectiveness of clinical decision support systems (CDSS), none of these are available for back pain management.ObjectiveThe objective of our study was to develop a Web-based CDSS to support Australian general practitioners (GPs) to diagnose and manage back pain according to guidelines.MethodsAsking a panel of international experts to review recommendations for sixteen clinical vignettes validated the tool. It was then launched nationally as part of National Pain Week and promoted to GPs via a media release and clinic based visits. Following this, a mixed methods evaluation was conducted to determine tool feasibility, acceptability, and utility. The 12 month usage data were analyzed, and in-depth, semistructured interviews with 20 GPs were conducted to identify barriers and enablers to uptake.ResultsThe tool had acceptable face validity when reviewed by experts. Over a 12 month period there were 7125 website visits with 4503 (63.20%) unique users. Assuming most unique users are GPs, around one quarter of the country’s GPs may have used the tool at least once. Although usage was high, GP interviews highlighted the sometimes complex nature of management where the tool may not influence care. Conversely, several “touch-points”, whereby the tool may exert its influence, were identified, most notably patient engagement.ConclusionsA novel CDSS tool has the potential to assist with evidence-based management of back pain. A clinical trial is required to determine its impact on practitioner and patient outcomes.

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