Impact of a Multipronged Education Strategy on Antibiotic Prescribing in Quebec, Canada

Weiss, Karl Heinz; Blais, Régis; Fortin, Anne; Lantin, Sonia; Gaudet, Michel

doi:10.1093/cid/cir409

Cited by 41 publications

(78 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…During the past decade, various studies from the United States of America (USA) and Australia have highlighted the importance of testing oropharyngeal and anorectal samples in addition to urogenital tests in MSM [7-14]. For example, a study in San Francisco showed that 53% of C. trachomatis and 64% of N. gonorrhoeae infections in MSM involved nonurethral sites and would be missed if screening was done only for urethral infection [7]. …”

Section: Introductionmentioning

confidence: 99%

Evaluation of sexual history-based screening of anatomic sites for chlamydia trachomatis and neisseria gonorrhoeae infection in men having sex with men in routine practice

Peters

Verweij

Nijsten³

et al. 2011

BMC Infect Dis

View full text Add to dashboard Cite

BackgroundSexually transmitted infection (STI) screening programmes are implemented in many countries to decrease burden of STI and to improve sexual health. Screening for Chlamydia trachomatis and Neisseria gonorrhoeae has a prominent role in these protocols. Most of the screening programmes concerning men having sex with men (MSM) are based on opportunistic urethral testing. In The Netherlands, a history-based approach is used. The aim of this study is to evaluate the protocol of screening anatomic sites for C. trachomatis and N. gonorrhoeae infection based on sexual history in MSM in routine practice in The Netherlands.MethodsAll MSM visiting the clinic for STI in The Hague are routinely asked about their sexual practice during consulting. As per protocol, tests for urogenital, oropharyngeal and anorectal infection are obtained based on reported site(s) of sexual contact. All consultations are entered into a database as part of the national STI monitoring system. Data of an 18 months period were retrieved from this database and analysed.ResultsA total of 1455 consultations in MSM were registered during the study period. The prevalence of C. trachomatis and N. gonorrhoeae per anatomic site was: urethral infection 4.0% respectively and 2.8%, oropharynx 1.5% and 4.2%, and anorectum 8.2% and 6.0%. The majority of chlamydia cases (72%) involved a single anatomic site, which was especially manifest for anorectal infections (79%), while 42% of gonorrhoea cases were single site. Twenty-six percent of MSM with anorectal chlamydia and 17% with anorectal gonorrhoea reported symptoms of proctitis; none of the oropharyngeal infections were symptomatic. Most cases of anorectal infection (83%) and oropharyngeal infection (100%) would have remained undiagnosed with a symptom-based protocol.ConclusionsThe current strategy of sexual-history based screening of multiple anatomic sites for chlamydia and gonorrhoea in MSM is a useful and valid guideline which is to be preferred over a symptom-based screening protocol.

show abstract

Section: Introductionmentioning

confidence: 99%

Evaluation of sexual history-based screening of anatomic sites for chlamydia trachomatis and neisseria gonorrhoeae infection in men having sex with men in routine practice

Peters

Verweij

Nijsten³

et al. 2011

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…Moreover, the goal of reducing overall antimicrobial prescribing may be better approached through a multi-faceted and multi-modal program with one of the facets being the strategic use of an antimicrobial formulary process. Success in reducing overall prescribing or prescribing of targeted drugs has been acquired through multifaceted programs such as “Do Bugs Need Drugs?” in British Columbia [30], “Les Antibiotiques C'est Pas Automatique” in France [31], and the multipronged educational program and guidelines for antimicrobial use in Québec [8].…”

Section: Discussionmentioning

confidence: 99%

“…CIPARS tracks temporal and regional trends in antimicrobial use and antimicrobial resistance in selected species of enteric bacteria obtained from both food production and from human clinical laboratory sources [8]. CIPARS monitors oral antimicrobial use as dispensed by outpatient pharmacies throughout Canada using the IMS Health Canada dataset.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Does Variation among Provincial Drug Formulary Antimicrobial Listings in Canada Influence Prescribing Rates?

et al. 2014

View full text Add to dashboard Cite

BackgroundThe financial accessibility of antimicrobial drugs to the outpatient community in Canada is governed at the provincial level through formularies. Each province may choose to list particular drugs or impose restriction criteria on products in order to guide prescribing and/or curtail costs. Although changes to formularies have been shown to change patterns in the use of individual products and alter costs, no comparison has been made among the provincial antimicrobial formularies with regards to flexibility/stringency, or an assessment of how these formularies impact overall antimicrobial use in the provinces.ObjectivesTo summarize provincial antimicrobial formularies and assess whether their relative flexibility/stringency had a statistical impact upon provincial prescription volume during a one year period.MethodsProvincial drug plan formularies were accessed and summarized for all prescribed antimicrobials in Canada during 2010. The number of general and restricted benefits for each plan was compiled by antimicrobial classification. Population-adjusted prescription rates for all individual antimicrobials and by antimicrobial class were obtained from the Canadian Integrated Program for Antimicrobial Resistance Surveillance. Correlations between the number of general benefits, restricted benefits, and total benefits with the prescription rate in the provinces were assessed by Spearman rank correlation coefficients.ResultsFormularies varied considerably among the Canadian provinces. Quebec had the most flexible formulary, offering the greatest number of general benefits and fewest restrictions. In contrast, Saskatchewan's formulary displayed the lowest number of general benefits and most restrictions. Correlation analyses detected a single significant result; macrolide prescription rates decreased as the number of general macrolide benefits increased. All other rates of provincial antimicrobial prescribing and measures of flexibility/stringency revealed no significant correlations.ConclusionsAlthough antimicrobial formulary listings are used to guide prescribing rates within a province, our analysis of one year's data of the impact of the antimicrobial formulary structure did not correlate with antimicrobial prescribing rates, and other factors are likely to be at play.

show abstract

“…Most of these PEMs presented a new medical advance or a high-risk condition or intervention. The second cluster includes 22 PEMs, among them 2 series of very similar PEMs that were prepared by the same developers: a series of 10 short references of clinical guidelines on antibiotic therapies studied by Weiss et al 27 (Appendix 2) and a series of 11 short Therapeutic Initiative newsletters studied by Dormuth et al 28 These PEMs were all relatively brief (less than 4 pages) and used communication strategies that involved "Appearance" concepts, such as special fonts, color, pictures, and graphics. They also scored significantly higher than the PEMs in the 2 other clusters on the "Organizers" and "Vibrancy or Intensity" items.…”

Section: Construct Validity-comparing the Communication Strategies Ofmentioning

confidence: 99%

The Communication AssessmenT Checklist in Health (CATCH): A Tool for Assessing the Quality of Printed Educational Materials for Clinicians

Genova

Nahón-Serfaty

Gagnon

et al. 2014

Journal of Continuing Education in the Health Professions

View full text Add to dashboard Cite

show abstract

Impact of a Multipronged Education Strategy on Antibiotic Prescribing in Quebec, Canada

Abstract: The implementation of guidelines significantly reduced antibiotic prescriptions in Quebec compared with the rest of the country, and there was a strong trend toward significant cost reduction.

Cited by 41 publications

References 19 publications

Evaluation of sexual history-based screening of anatomic sites for chlamydia trachomatis and neisseria gonorrhoeae infection in men having sex with men in routine practice

Evaluation of sexual history-based screening of anatomic sites for chlamydia trachomatis and neisseria gonorrhoeae infection in men having sex with men in routine practice

Does Variation among Provincial Drug Formulary Antimicrobial Listings in Canada Influence Prescribing Rates?

The Communication AssessmenT Checklist in Health (CATCH): A Tool for Assessing the Quality of Printed Educational Materials for Clinicians

Contact Info

Product

Resources

About