Abstract
The purpose of this quality improvement project evaluates the effectiveness of patient supportive treatment cards as a tangible item received from the office visit in relation to patient satisfaction and URI antibiotic guideline adherence. Improper prescribing of antibiotics and lack of following clinical guidelines for an URI, a leading clinical diagnosis, is increasing antibiotic resistance. During a 15 minute education seminar, the providers are introduced to the patient supportive treatment cards and current clinical guidelines. For patients that merit non- antibiotic treatment for upper respiratory infections, the provider indicates on the supportive treatment card appropriate supportive treatment options for the patient. Each supportive treatment card has a variety of supportive therapy options. The utility of the patient supportive treatment cards is evaluated by comparing pre- and post-intervention antibiotic prescription rates. Charts are evaluated for guideline adherence and patients warranting antibiotics. Those that receive an antibiotic are also reviewed for adherence to recommended first-line therapy. Surveys via phone calls to patients using a Likert scale evaluate patient satisfaction with the supportive treatment cards. First-line antibiotic therapy was used 33% of the time pre-intervention and 23% post-intervention. We compared the proportion of patients who incorrectly received an antibiotic from pre (16 out of 40 patients) to those who incorrectly received an antibiotic during the intervention period (20 out of 77 patients), this proportion, χ2 = 1.248, p = .26. The result is not significant at p < .05. However, it represents a potential 15% decrease in the incorrect prescription of antibiotics. A tangible item, such as the patient supportive treatment card, provides a potential simple intervention to reduce the number of inappropriate antibiotic prescriptions. With patient satisfaction maintained during this study, future studies should focus on larger sample sizes for generalizability and procedures to ensure eligible patients are receiving the tangible item.|Keywords: antibiotic resistance, upper respiratory infection, inappropriate antibiotic use, patient satisfaction, bronchitis, rhinosinusitis, pharyngitis