Medico-economic evaluation of an educational intervention to optimize children uncomplicated nasopharyngitis treatment in ambulatory care.

Objectives-To study the medico-economic impact of an educational procedure devoted to promote symptomatic treatment of acute nasopharyngitis toward me dical practitioners and patients. Methods and patients - Open randomized comparative study on two groups of m edical practitioners; one being aware of specific educational procedures an d using informative documents for parents, the other using the procedures t hey were used to. Patients: children aged under ten, with acute uncomplicat ed nasopharyngitis since nine days maximum and not treated by antibiotics. Evaluation: clinical evolution after seven days, costs due to medical fees, to drugs and to the other investigations. Results - Three thousand and seven hundred sixty four children have been in cluded in the study: 1957 in the 'educational procedure' group and 1807 in the 'usual procedure' group. Clinical evolution appears similar between gro ups. The economic study shows that, whereas the efficacy indicators give co mparable results, the educational procedure leads to a decrease of pharmace utical expenses: - 10.8% when considering the purchase costs, - 18.9% takin g into account the private insurance reimbursements and - 22.0% for the nat ional insurance reimbursements. The costs due to medical fees and to paracl inical investigations are comparable between groups. The expenses decrease is mainly due to a decrease in antibiotic prescriptions (26.7% versus 37.1% ). Conclusion - This study shows that the promotion of educational procedures leads to a reduction of antibiotic prescriptions without any risk for the p rognosis of children acute nasopharyngitis. This rationalisation of antibio tic prescription may contribute to restrict the development of bacteriologi cal resistance. It also reduces significantly healthcare costs. (C) 2000 Ed itions scientifiques et medicales Elsevier SAS.