An international study comprising researchers from the University of Gothenburg has demonstrated that a decision-making tool for healthcare providers can reduce the usage of antibiotics for urinary tract infections by halving it while maintaining patient safety.
A total of 1,041 frail elderly adults from 38 senior living facilities in the Netherlands, Norway, Poland, and Sweden participated in the study, which has just been published in The BMJ. The Swedish portion of the study, which involves 207 participants, has been conducted by a team of researchers from Region Västra Götaland and the University of Gothenburg.
The study’s context is the overprescribing of medicines to elderly patients with suspected urinary tract infections (UTIs). The researchers have consequently created a multifactorial training program (a “multifaceted antibiotic” in the context of the international collaboration).
The interactive training program consisted of theory instruction followed by discussion in small groups about optimal care for seniors with suspected UTIs. A decision tool with associated educational and information material was used. Doctors, nurses, and nurse assistants taking part devised action plans adapted for their own respective workplaces, and these were followed up.
The results show that the intervention was indeed effective: The outcome was a halving of the number of UTI antibiotic courses of treatment compared with the control group. The reduced number of prescriptions was 0.27 per person-year, against 0.58 for the control group — a difference that is both clinically relevant and statistically significant.
The study also shows that patient safety was unaffected. There were no intergroup differences in terms of complications, hospitalizations, or deaths ensuing from UTIs. The research was conducted in the period from September 2019 to June 2021.
