On 2015 Jul 13, CREBP Journal Club commented:

The authors concluded that the “use of written information leaflets in general practice consultations are effective in reducing antibiotic prescribing, and actual antibiotic use by patients and their intention to reconsult for future episodes of illness. It is unclear whether information leaflets also actually affect reconsultation rates.”

The group generally agreed that this was a well conducted review and liked the arrangement of the data in Table 3. We discussed a number of areas:

In this review, two reviewers screened 200 titles and abstracts (with no disagreements) and a single author screened the rest with double checking by a second. We noted that individual reviewers miss around 3% of articles; thus, this approach may have led to a number of missed articles (Doust et al 2005).

The authors stated they would exclude multifaceted interventions but included a study by Francis et al. 2009. It included both information and training in delivering of the intervention (and some members of the journal club believed it could be classed as a shared decision-making intervention). However, the authors did acknowledge this training and stated that it may have affected the results of this study.

The authors assessed the risk of bias as high for blinding of participants and personnel for each study. GRADE processes suggest that the risk of bias for blinding should be assessed for each outcome (rather than study) so that the objectivity or subjectivity of the specific outcome measure can be taken into account when deciding on whether bias was likely.

Overall, we believed this was a well conducted review. Clinicians in the journal club had a lively debate about whether they would use information for their patients with common infections. We concluded that it was one tool that you could have in your toolkit to help minimise antibiotic use and the risk of antibiotic resistance.

References:

Doust et al. Identifying studies for systematic reviews of diagnostic tests was difficult due to the poor sensitivity and precision of methodologic filters and the lack of information in the abstract. Journal of Clinical Epidemiology 2005; 58 (5): 444-449

Francis et al. Effect of using an interactive booklet about childhood respiratory tract infections in primary care consultations on reconsulting and antibiotic prescribing; a cluster randomised controlled trial. BMJ 2009; 339:b2885

O’Sullivan et al. Written information for patients on the use of antibiotics in acute upper respiratory infections in primary care. Cochrane Database of Systematic Reviews 2014; Issue 10: CD011360.

Full journal club report: CREBP Journal Club

On 2015 Jul 13, CREBP Journal Club commented:

The authors concluded that the “use of written information leaflets in general practice consultations are effective in reducing antibiotic prescribing, and actual antibiotic use by patients and their intention to reconsult for future episodes of illness. It is unclear whether information leaflets also actually affect reconsultation rates.”

The group generally agreed that this was a well conducted review and liked the arrangement of the data in Table 3. We discussed a number of areas:

In this review, two reviewers screened 200 titles and abstracts (with no disagreements) and a single author screened the rest with double checking by a second. We noted that individual reviewers miss around 3% of articles; thus, this approach may have led to a number of missed articles (Doust et al 2005).

The authors stated they would exclude multifaceted interventions but included a study by Francis et al. 2009. It included both information and training in delivering of the intervention (and some members of the journal club believed it could be classed as a shared decision-making intervention). However, the authors did acknowledge this training and stated that it may have affected the results of this study.

The authors assessed the risk of bias as high for blinding of participants and personnel for each study. GRADE processes suggest that the risk of bias for blinding should be assessed for each outcome (rather than study) so that the objectivity or subjectivity of the specific outcome measure can be taken into account when deciding on whether bias was likely.

Overall, we believed this was a well conducted review. Clinicians in the journal club had a lively debate about whether they would use information for their patients with common infections. We concluded that it was one tool that you could have in your toolkit to help minimise antibiotic use and the risk of antibiotic resistance.

References:

Doust et al. Identifying studies for systematic reviews of diagnostic tests was difficult due to the poor sensitivity and precision of methodologic filters and the lack of information in the abstract. Journal of Clinical Epidemiology 2005; 58 (5): 444-449

Francis et al. Effect of using an interactive booklet about childhood respiratory tract infections in primary care consultations on reconsulting and antibiotic prescribing; a cluster randomised controlled trial. BMJ 2009; 339:b2885

O’Sullivan et al. Written information for patients on the use of antibiotics in acute upper respiratory infections in primary care. Cochrane Database of Systematic Reviews 2014; Issue 10: CD011360.

Full journal club report: CREBP Journal Club