Efforts should be made to reduce antibiotic prescribing for this condition. Stewart and colleagues recently reported a reduction in antibiotic prescribing (—9.4%) in an Ontario community after an educational strategy was developed. The two main messages from this intervention program were not to use antibiotic for viral respiratory infections and to use drugs recommended in the Anti-infective Guidelines for Community-acquired Infections. Physicians, pharmacists and the public were targeted by this program. These authors also reported that physicians were 29% less likely to prescribe second line antibiotics after the intervention program. buy ortho tri-cyclen
An important issue that has been identified in the literature is the fact that clinical practice guidelines are not always followed by physicians. A recent review reports that there are seven general categories of barriers that may prevent guideline adherence. These barriers may affect physician knowledge (lack of awareness or lack of familiarity), attitudes (lack of agreement, lack of self-efficacy (physician believes that he/she cannot perform guideline recommendations), lack of outcome expectancy (the inertia of previous practice), or behaviour (external barriers) . When attempting to disseminate the information from clinical practice guidelines, it is important to be aware of these barriers. It has also been reported that continuing medical education is more effective when it incorporates practice-based, enabling and reinforcing strategies. The assessment of physicians’ needs may also lead to the increased potential for change in performance. Some strategies that have been shown to influence physician performance include academic detailing (visits by trained physician educators such as pharmacists), practice reminders, feedback system and educational leaders.