Kaiser Permanente reduced antibiotic prescriptions through physician education, computer alerts

Kaiser Permanente physicians in Southern California were found to have reduced the odds of prescribing an antibiotic for sinusitis by 22% through the use of computer alerts to inform doctors when antibiotics may not be the best course of treatment. The study, which examined the effect of provider education and clinical decision support on antibiotic prescribing on how patients rate their overall satisfaction with a visit, found that:

• Antibiotics were correlated with 4% higher patient satisfaction scores;
• More than three in four patients were satisfied with a visit even when not prescribed antibiotics for acute sinusitis;
• Clinical decision support was associated with a 22% decrease in antibiotic use post-intervention, but the absolute reduction was small (2%);
• Provider education had a large initial effect, but it wasn't sustained over the study period;
• The intervention was associated with a substantial decrease in acute sinusitis diagnoses, compared to other common upper respiratory diagnoses; and
• The effect of decision support did not appear to vary based on doctors' experience.