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Behaviour change interventions reduced antibiotic prescribing by 21 per cent – DoH paper

By Reporter - 30th Aug 2024

Minister for Health Stephen Donnelly has today published a research paper entitled Changing Behaviour: Reducing Unnecessary Antibiotic Prescribing.

The systematic review and meta-analysis, conducted by the strategic research and evaluation unit in the Department of Health, in conjunction with the University of Limerick, shows how behaviour change interventions reduced antibiotic prescribing by 21 per cent.

It evaluated international evidence across 22 international controlled trials and 23,000 patient consultations, to provide estimates of the overall effect of behaviour change interventions seeking to reduce unnecessary prescribing.

The finding of intervention effectiveness holds across geography (Europe versus North America), publication year (studies published up to and including 2010, relative to the subsequent decade), and intervention target group (practitioner and patient versus practitioner alone). The finding also holds after allowing for possible risk of bias and after undertaking sensitivity analyses.

The paper will help to inform the Department’s ongoing work on antimicrobial resistance (AMR), which occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines.

AMR is classified by the World Health Organisation (WHO) as one of the top 10 threats to public health. It poses a significant threat to the health service through reduced treatment options for infections, while also imposing a large financial burden on the State.

AMR has previously been estimated to cost the Irish health service at least €12 million annually and to account for an estimated 215 attributable deaths in a year.

Promoting AMR research is a strategic objective of the WHO Global Action Plan 2015 and Ireland’s second One Health Action Plan on Antimicrobial Resistance 2021-2025 (iNAP2).

Interim Chief Medical Officer, Prof Mary Horgan, said: “This results in this paper indicate that behaviour change interventions reduced antibiotic prescribing by 21 per cent across 22 studies and 23,000 patient consultations.

“Tackling AMR is a complex cross-sectoral issue, but this research provides valuable evidence of the important role of prescribers, showing how well-designed education and communication training for general practitioners (GPs), the use of decision support tools and of delayed prescribing practices by GPs can reduce unnecessary antibiotic use.”

Chief Nursing Officer Ms Rachel Kenna said: “Research on AMR is an important strategic objective in Ireland’s second One Health Action Plan on Antimicrobial Resistance (iNAP2).

“As we prepare for the development of the next one health action plan, this paper adds to the growing body of data that will help to ensure that Ireland’s strategy is based on the best international evidence available.” 

Minister Donnelly said: “We know that behavioural science plays a critical role in addressing the threat of AMR by reducing unnecessary prescribing, and the paper I’m publishing today provides useful insights to assist Ireland’s work in tackling this significant public health risk.

“To protect our population, and our health service, we must ensure that antibiotics are only prescribed when necessary and appropriate to minimise resistance and to ensure that patients can continue to access them when they really need them.”

A copy of Changing Behaviour: Reducing Unnecessary Antibiotic Prescribing. Systematic Review and Meta-analysis can be viewed here – https://www.gov.ie/en/publication/63c7e-changing-behaviour-reducing-unnecessary-antibiotic-prescribing-a-systematic-review-and-meta-analysis/

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The Medical Independent 10th September 2024

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