Impact of a Social Marketing Intervention on General Practitioners’ Antibiotic Prescribing Practices for Acute Respiratory Tract Complaints in Malta

Abstract

Introduction: Antibiotics are commonly prescribed in primary care for acute respiratory tract complaints (aRTCs), often inappropriately. Social marketing interventions could improve prescribing in such settings. We evaluate the impact of a social marketing intervention on general practitioners’ (GPs’) antibiotic prescribing for aRTCs in Malta. Methods: Changes in GPs’ antibiotic prescribing were monitored over two surveillance periods between 2015 and 2018. Primary outcome: change in antibiotic prescription for aRTCs. Secondary outcomes: change in antibiotic prescription: (i) for immediate use, (ii) for delayed antibiotic prescription, (iii) by diagnosis, and (iv) by antibiotic class. Data were analysed using clustered analysis and interrupted time series analysis (ITSA). Results: Of 33 participating GPs, 18 successfully completed the study. Although clustered analyses showed a significant 3% decrease in overall antibiotic prescription (p = 0.024), ITSA showed no significant change overall (p = 0.264). Antibiotic prescription decreased significantly for the common cold (p < 0.001), otitis media (p = 0.044), and sinusitis (p = 0.004), but increased for pharyngitis (p = 0.015). Conclusions: The intervention resulted in modest improvements in GPs’ antibiotic prescribing. A more top-down approach will likely be required for future initiatives to be successful in this setting, focusing on diagnostic and prescribing support like rapid diagnostic testing, prescribing guidelines, and standardised delayed antibiotic prescriptions.

Marketing in social innovations targeted at healthcare

“…As has already been mentioned, the first campaigns focused on the struggle against smoking or HIV/AIDS. At present, they are being used in principle in any context relating to health where the most resonant issues lately involve healthy diet (Fergus et al, 2021;Mostafavi et al, 2021), mental health (Potts and Henderson, 2021), seniors' health (Yasumoto and Gondo, 2021), or the issue of prescription drugs (Machowska et al, 2021). Equally so, the current pandemic of COVID-19 required the implementation of innovative marketing techniques and social marketing techniques (Svec and Mura, 2020;Evans and French, 2021).…”