Feedback from other doctors improves antibiotic prescribing decisions

Expert feedback can be an effective way to encourage doctors to make more appropriate antibiotic treatment decisions, according to new research by the University of Cologne.

The study found that providing paediatricians with simple directional feedback significantly reduced the length of antibiotic therapies by an average of 10 per cent.

Doctors often prescribe antibiotics when it is not absolutely necessary and excessive use of antibiotics can not only promote the development of antibiotic resistance, but can have negative health consequences, especially in children.

Using a controlled decision-making experiment, Professor Daniel Wiesen and his co-authors saw the casual effect of feedback on therapy decisions of individual doctors and how a simple and small nudge could lead to physicians improving their antibiotic prescribing behaviour.

The study also found that expert feedback was most effective for paediatricians with little experience and compensates, to some extent, for the lack of experience.

“We were surprised that such a simple informational nudge like the provision of expert feedback can have such a substantial effect on antibiotic prescribing decisions. The experiment shows that individual characteristics – such as how experienced or how risk-taking the prescribing physician is -influence the decisions and the effect of feedback,” says Professor Wiesen.

The study was part of the interdisciplinary project ‘ at the University of Cologne, funded by the Excellence Initiative of the German federal and state governments. It was published in the peer-reviewed scientific journal Medical Decision Making.

The study, “The Effect of Expert Feedback on Antibiotic Prescribing in Paediatrics: Experimental Evidence”, was conducted by Daniel Wiesen in collaboration with Kerstin Eilermann, Katrin Halstenberg, Ludwig Kuntz, Kyriakos Martakis, and Bernhard Roth.