Clinical Trial Summary
At the international level, several experiments have been conducted to modify antibiotic
prescribing practices in GPs. The mere development of training or the mere provision of
information on the internet do not seem to change the practices when these interventions are
conducted in isolation. On the other hand, various approaches involving communication
training, specific educational interventions working on ideas received from examples,
interventions at the point of care, and the use of electronic decision support systems have
demonstrated beneficial effects on prescription. The fact of sending feedback on their
prescribing practices back to GPs also showed an impact
The Antibioclic website was created in 2011. It is an internet tool for prescribing help
developed for general practitioners. Every day, it is consulted on average by 9000 health
professionals. One question is how far the use of the site makes it possible to modify
prescribing practices, which would justify, if need be, to actively promote it to general
practitioners who do not use it. (The council of the order of doctors counted a little more
than 88000 general practitioners in 2018.)
One challenge would be to implement a strategy:
- combining different actions that have shown their impact: visit to the place of care,
awareness of antibiotic resistance, work on preconceived ideas, feedback on practices,
use of decision support tools,
- and generalizable nationally.
The proposed study will thus experiment with an intervention modality based on the visit of a
medical representative in general practitioner facilities, with:
- antibiotic resistance sensitization,
- work on preconceived ideas,
- feedback on prescriptions,
- use of an Internet tool to assist in the prescription of antibiotics: Antibioclic.
The generalizability of the intervention will be based on the collaboration with the medical
representatives , which already intervene in an operational and regular way on this topic on
the whole France. The medical representatives, distributed throughout the country, provide
regular visits to the GPs and promote good practices. This type of visit to GPs is original
internationally, demonstrating its impact on practices is decisive.
The purpose of the research is to compare the effect on antibiotic prescriptions made by
general practitioners after 12 months of follow-up, i) an intervention led by the medical
representatives in general practitioner facilities, the intervention involving usual visit
(antibiotic resistance sensitization, work on preconceived ideas, feedback on practices) and
demonstration of the use of Antibioclic, ii) an intervention conducted on the same terms by
the the medical representatives but without Antibioclic demonstration, iii) compared to usual
practice.
