AHRQ Innovations Exchange | Online Tutorial and Interactive Workshop Support Physicians in Employing Shared Decisionmaking With Patients, Reducing Antibiotic Use for Acute Respiratory Infections

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AHRQ Innovations Exchange | Online Tutorial and Interactive Workshop Support Physicians in Employing Shared Decisionmaking With Patients, Reducing Antibiotic Use for Acute Respiratory Infections

Online Tutorial and Interactive Workshop Support Physicians in Employing Shared Decisionmaking With Patients, Reducing Antibiotic Use for Acute Respiratory Infections

Snapshot

Summary In a cluster randomized trial, family practice physicians completed a 2-hour online tutorial followed by a 2-hour interactive workshop, both of which included videos, reflective exercises, and decision aids designed to support them in engaging in shared decisionmaking with patients presenting with signs of an acute respiratory infection. Known as DECISION+2, this program is a streamlined version of a more comprehensive package (DECISION+) that featured two additional workshops, periodic written reminders, and feedback on the degree of decisional conflict in patients versus physicians. The streamlined program reduced use of antibiotics for acute respiratory infections and allowed patients to take a more active role in decisionmaking, without having a negative impact on patient outcomes. The earlier, more comprehensive program also reduced antibiotic use, and generated high levels of physician satisfaction and greater agreement between physicians and patients on their level of comfort with the decision. Evidence Rating (What is this?) Strong: The evidence consists primarily of a cluster randomized trial that included 181 patients consulting with physicians in five family medicine practices that participated in the DECISION+2 program to 178 patients consulting with physicians in four similar family practices that did not. Additional evidence comes from a smaller trial of the more comprehensive DECISION+ program that involved two participating family medicine groups and two similar control-group sites. Developing Organizations Université Laval, Department of Family Medicine and Emergency Medicine Date First Implemented 2007 The trial of DECISION+ ran from November 2007 to April 2008; the second, larger trial of DECISION+2 ran from November 2010 through April 2011.