Antibiotics are still being prescribed too often in Switzerland. But tools are now available to assist general practitioners with shared decisions on whether to prescribe antibiotics. They help the doctor to advise their patients and are also suitable for further training in quality circles. A research team from the Institute of Primary Health Care in Bern recently received an award from the Swiss Society for General Internal Medicine for this innovative tool.
By European standards, antibiotic use in Switzerland is relatively low. However, there is still room for improvement. In the French- and Italian-speaking regions in particular, antibiotic use is significantly higher than in German-speaking Switzerland. Scientists from the Bern Institute of Primary Health Care (BIHAM) estimate that about half of antibiotic prescriptions are unnecessary as they are given for infections that are self-limiting (i.e. not requiring treatment) or for viral infections.
Support with advice
A team of researchers from BIHAM set themselves the goal of improving the situation with regard to the prescribing of antibiotics. The title of their project is "Development of tools to implement shared decision-making for guideline recommended antibiotic prescriptions in primary healthcare physician practices in Switzerland". The two-year development period yielded practical tools that GPs and paediatricians can now use for advising their patients.
Fewer antibiotics – and an award
With the BIHAM advisory model, patients are involved in the decision-making process. This has already proven its worth: if patients are properly informed, they are more likely to consider therapeutic options not involving antibiotics. The project is thus contributing in an innovative way to a reduction in antibiotic use in Switzerland. Hence the decision of the research foundation of the Swiss Society for General Internal Medicine (SGAIM) to award the project prize money of 50,000 Swiss francs for further development and evaluation.
Involvement of professionals and patients
The tools were developed during a two-year development period together with a broad-based interprofessional group of experts from the fields of epidemiology and infectiology. The group also included patients. The tools were tested for practicality at three general practices, and the GPs involved in the project provided feedback that helped to gradually improve the tools.
A bigger toolbox
At present, the tools cover the following indications for which antibiotics are frequently prescribed in outpatient care:
- Middle ear infection (otitis media)
- Sore throat (tonsillopharyngitis)
- Acute uncomplicated urinary tract infection
With the help of the prize money plus other support from the FOPH, the BIHAM team will extend the tools to other indications. In addition, moderation guidelines for quality circles are being devised.
The tools can be downloaded from the Institute of Primary Health Care website in German, French and English. For each indication, a two-page evidence-based summary of key facts is available, plus an information sheet for consultation in which the advantages and drawbacks of treatment with or without antibiotics are illustrated with easy-to-understand graphics. These tools are ideally suited for use as thought-provoking pointers and training aids in quality circles.
Last modification 11.09.2023
