Pledges Reduce Inappropriate Antibiotic Prescribing Rates

Cheryl Clark, January 28, 2014

In a study, antibiotic prescription rates for antibiotic-inappropriate diagnoses dropped after clinicians posted photos of themselves alongside signed pledges to "avoid prescribing antibiotics when they are likely to do more harm than good."

Clinicians are less likely to inappropriately prescribe antibiotics if they sign and display "commitment" pledges—with photos of themselves—on their exam room walls, says a paper by researchers in Boston and Los Angeles.

"We found this is a new way to improve healthcare through medicine," says one of the authors, Jason N. Doctor, a health economist at the University of Southern California School of Pharmacy.

"In the past, we've focused on [preventing inappropriate prescribing by] stopping [doctors'] work flow by giving them alerts and reminders, trying to appeal to reason and educating them.

"What we did here is we treated these doctors more like social animals who are affected more by social interactions with others," Doctor says. "We leveraged the fact that these physicians want to appear consistent, and when we hold them accountable through this commitment device, we found that they do change their behavior."

The paper was published in Monday's issue of JAMA Internal Medicine. The research project was funded by the National Institute on Aging. Researchers from Brigham and Women's Hospital in Boston, Harvard Medical School, and the University of California Los Angeles, and clinicians from Queens Care Family Clinics in Los Angeles participated.

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