EFFECT OF AN EXPLICIT DECISION-SUPPORT TOOL ON DECISIONS TO PRESCRIBEANTIBIOTICS FOR SORE THROAT

Studies of scoring rules for sore throat have failed to show that they lower antibiotic prescription rates. The authors studied the effect o f an explicit decision-support tool, incorporating a modified score, o n antibiotic-prescription decisions. Four hundred and fifty family phy sicians received an information package, a score card, and a recording form to use during one sore-throat encounter. The physicians randomly received either a control form or an intervention form that required them to interact with the score during the clinical recording process. There was a trend towards a reduction in antibiotic prescriptions (21 %, p = 0.09) in the physicians using the intervention form. A greater reduction (45%, p = 0.06) was observed for patients whose probabilitie s of infection with group A streptococcus were low. Sore-throat-scorin g rules may reduce unnecessary antibiotic prescriptions if physicians are specifically cued to use them during clinical encounters and appro priate management responses are linked to score estimates for the like lihood of group A streptococcus infection.