Enhanced Communication Skills and C-reactive Protein Point-of-Care Testing for Respiratory Tract Infection: 3.5-year Follow-up of a Cluster Randomized Trial

The Article in Brief

Enhanced Communication Skills and C-Reactive Protein Point-of-Care Testing for Respiratory Tract Infection: 3.5-Year Follow-up of a Cluster Randomized Trial

Jochen W. L. Cals , and colleagues

Background Reducing overprescribing of antibiotics for respiratory tract infections (RTIs) is essential in an era of increasing antimicrobial resistance. This study assesses the long-term effects of 2 interventions on office visit rates and antibiotic prescribing for patients with RTIs; the interventions are family physicians' use of C-reactive protein point-of-care testing, a widely used means of diagnosing and monitoring infections, and physician training in communication skills.

What This Study Found The study found mixed results. An office visit with a family physician who used C-reactive protein point-of-care testing and/or who was trained in enhanced communication skills had no effect on the rate of office visits for respiratory tract infection episodes during the next 3.5 years. However, patients managed by a family physician trained in enhanced communication skills were less likely to receive antibiotics for RTI episodes during the 3.5-year follow-up. Specifically, family physicians trained in communication skills treated 26 percent of all episodes of respiratory tract infection with antibiotics compared with 39 percent treated by family physicians without such training. The cluster-randomized controlled trial included 379 patients at 20 family practices in the Netherlands.

Implications

• The authors call for implementation of both interventions on a larger scale, noting that training physicians in the use of enhanced communication skills may have a wider longer-term effect on the treatment of respiratory tract infections beyond acute cough to include reduced antibiotic prescribing.