{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:33:04Z","timestamp":1780374784155,"version":"3.54.1"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T00:00:00Z","timestamp":1561939200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Foundation for Science and Technology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia\/FCT","award":["PTDC\/SAU-ESA\/105530\/2008"],"award-info":[{"award-number":["PTDC\/SAU-ESA\/105530\/2008"]}]},{"name":"Portuguese Ministry of Science and Education"},{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Fundo Europeu para o Desenvolvimento Regional\/FEDER"},{"DOI":"10.13039\/501100011929","name":"Operational Competitiveness Programme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011929","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Programa Operacional Fatores de Competitividade\/COMPETE Program"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>High rates of antibiotic misprescribing in primary care, with alarming clinical and economic consequences, highlight the urgent need for interventions to improve antibiotic prescribing in this setting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the effectiveness on antibiotic prescribing quality indicators of a multifaceted intervention targeting health professionals\u2019 and patients\u2019 behaviour regarding antibiotic use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a pragmatic cluster-randomized controlled trial in the catchment area covered by Portugal\u2019s Central Regional Health Administration. The intervention consisted of a multidisciplinary, multifaceted programme involving physicians, pharmacists and patients, and comprising outreach visits for physicians and pharmacists, and educational materials for health professionals and patients. The following were assessed: relative ratios of prescription of penicillins sensitive to \u03b2-lactamase, penicillin combinations including \u03b2-lactamase inhibitors, third- and fourth-generation cephalosporins and fluoroquinolones; and the ratio of broad- to narrow-spectrum antibiotics. An interrupted time-series analysis for multiple-group comparisons was performed. The study protocol was registered on Clinical.trials.gov (NCT02173509).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The participation rate in the educational intervention was 64% (197\/309 GPs) in a total of 25 counties. Statistically significant improvements were obtained, not only in the relative prescription of penicillins sensitive to \u03b2-lactamase (overall relative change of +896%) and penicillin combinations including \u03b2-lactamase inhibitors (\u2212161%), but also in the ratio of broad- to narrow-spectrum antibiotics (\u2212200%). Statistically significant results were also obtained for third- and fourth-generation cephalosporins, though only in the immediate term.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study showed that quality indicators of antibiotic prescribing can be improved by tackling influences on behaviour including knowledge and attitudes surrounding physicians\u2019 clinical practice. Accordingly, these determinants must be considered when implementing interventions aimed at improving antibiotic prescribing.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkz244","type":"journal-article","created":{"date-parts":[[2019,6,12]],"date-time":"2019-06-12T07:51:38Z","timestamp":1560325898000},"page":"2788-2796","source":"Crossref","is-referenced-by-count":21,"title":["Effectiveness of an intervention to improve antibiotic-prescribing behaviour in primary care: a controlled, interrupted time-series study"],"prefix":"10.1093","volume":"74","author":[{"given":"Ant\u00f3nio","family":"Teixeira Rodrigues","sequence":"first","affiliation":[{"name":"Institute of Biomedicine - iBiMED, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal"},{"name":"Faculty of Pharmacy, University of Coimbra (FFUC), Coimbra, Portugal"},{"name":"Centre for Health Evaluation and Research (CEFAR), National Association of Pharmacies, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e1tima","family":"Roque","sequence":"additional","affiliation":[{"name":"Institute of Biomedicine - iBiMED, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal"},{"name":"Research Unit for Inland Development, Polytechnic of Guarda (UDI\/IPG), Guarda, Portugal"},{"name":"Health Science Research Centre, University of Beira Interior (CICS\/UBI), Covilh\u00e3, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Pi\u00f1eiro-Lamas","sequence":"additional","affiliation":[{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiolog\u00eda y Salud P\u00fablica-CIBERESP), University of Santiago de Compostela, Santiago de Compostela, Spain"},{"name":"Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, 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