Effective Briefing
With a simple brochure, researchers were able to convince a large group of doctors in Britain to prescribe less antibiotics. In the scientific journal ‘Lancet’ they are talking about their experiences.
Most antibiotics taken by patients are consumed at home, not in the hospital. In Britain, the proportion is roughly 80 to 20. However, a large part of the antibiotics swallowed at home could be done without.
Why? On the one hand, patients ask their doctors for antibiotics when they actually are not useful – for example, when they have a cold. On the other, doctors are too careless when prescribing antibiotics. A British study shows that roughly one in four antibiotics is prescribed in cases where the doctor is not sure whether it is necessary at all.
How can we end this abuse? According to researchers led by Michael Hallsworth at London’s „Behavioral Insights Team“ this is surprisingly easy. First, the researchers visited those 20 percent of the British medical practices that prescribed most antibiotics in their region. In order to get the data, the researchers referred to public databases.
After that, they separated the band of almost 1600 medical practices into two groups. The scientists wrote a letter to every second medical practice explaining to the doctors that they were prescribing a particularly large number of antibiotics. The researchers said that this was a simple psychological trick because it moves the affected doctors to the position of an outsider. Also, they added a note by the British „Chief Medical Officer“ to the letter.
This simple measure already had its effects: The prescription of antibiotics in those very medical practices decreased by three percent in comparison to the group of doctors who did not receive a letter.
Three percent, that does not sound like much. However, taking into account the number of almost 800 practices, this amounts to more than 70,000 less prescriptions of antibiotics in half a year, as experts estimate. This would cost the NHS almost 100,000 pounds less at an expense of not even 5000 Euros for printing and sending the brochures. And yet the researchers do not even know how many of the doctors opened and read the letter at all.
Since the measure worked that well they sent the letters to the other half of the practices that served as a comparison group as well. Immediately their usage of antibiotics declined, too.
The study, however, also portrays more obstacles to a reduced consumption of antibiotics: It is much more difficult to explain the problem of thoughtlessly swallowed antibiotics to patients. Again, the researchers separated the 1600 practices into two groups. One half received posters and brochures in order to inform patients. Yet, nothing happened and the rate of antibiotics prescriptions remained high.
The conclusion of the researchers: Either the participants of this study are unwilling to listen to reason or they are that packed with information on antibiotics already that a brochure does not make a difference. As a major part of the global efforts to reduce consumption of antibiotics aims at the individual responsibility of patients, this is anything but a good message.
Doctors, in contrast, seem to be more receptive regarding advice. The British scientists expect the awareness campaign to be able to reduce consumption of antibiotics outside of hospitals by almost one percent in the short run. This would be a major step in the direction of those four percent the government aims at in its struggle to reduce consumption of antibiotics in the UK.
Whether this path makes sense for other countries as well remains unclear: The British scientists profited from the fact that in the UK, data of prescriptions in each practice are made, thanks to the NHS, available to the public in a single location. In Germany, for example, this is not the case.
