May 7, 2020   SOURCE: PR NewsWire

Medscape and FDA Study Shows Potential of Digital Communication to Drive Practice Change, Improve Public Health

NEW YORK, May 7, 2020 /PRNewswire/ -- Targeted short-form messaging, combined with digital continuing medical education (CME) to clinicians, was found to significantly reduce the inappropriate prescribing of antibiotics, according to the results of a new study, conducted by Medscape in collaboration with the U.S. Food and Drug Administration (FDA), and published in Pharmacy Practice.

The study examined whether short-form messaging (emails, web alerts, and mobile alerts) and digital CME could impact the volume of first-line fluoroquinolone prescriptions in conditions where they are contraindicated. The third most frequently prescribed class of drugs in the U.S., fluoroquinolones carry an FDA "black box" warning due to a range of potentially disabling and irreversible reactions including musculoskeletal and peripheral nervous system conditions; central nervous system disorders; significant decreases in blood sugar and attendant risk for coma; and ruptures or tears in the aorta.(1)

"Our findings show that effective and targeted digital communication and online education can have a powerful impact on clinical behaviors," said John Whyte, MD, MPH, lead study author and Chief Medical Officer of WebMD. "In addition to reducing the inappropriate prescribing of fluoroquinolones, these findings could prove highly relevant in the age of Covid-19, when changes in clinical data and guidance demand that clinicians receive swift and accurate dissemination of information to improve care and safeguard public health."

Previous studies have shown that 5% of all fluoroquinolone prescriptions in the U.S. were given for conditions for which no antibiotics are indicated, and 20% were given for conditions for which fluoroquinolones are not recommended first-line therapy, including 6.3 million for sinusitis and uncomplicated urinary tract infections, and 1.6 million for viral respiratory tract infections and bronchitis.(2)

The study randomized clinicians to one of three groups: One received short-form messages only (n=8,895); a second, CME activity only (n=1,756); and a third, both short-form and CME (n=1,123). A fourth study arm, which matched study clinicians to third-party provider prescribing data, served as the control. Overall, new prescription volume decreased 10.3%, ranging from 8.5% for short-form messaging only to 21.7% for a combination of short-form messaging and CME. The results were statistically significant.


                   Tactic/Message              Test Cohort (n)          New prescriptions volume %            p-value
                                                               difference compared w/control

    ---


       All Tactics               
     Total (n=11,774)                                        -10.3% 
     p<0.0001

    ---

        Short-form Message        
     Total (n=8,895)                                          -8.5% 
     p<0.0001

    ---


       CME                         CME Only Participants
                                     (n=1,756)                                              -12.3% 
     p=0.0004

    ---

        CME & Short-form Message  
     Total (n=1,123)                                         -21.7% 
     p<0.0001

    ---

"This study demonstrates that a digital approach to education, which we have practiced for over 25 years, offers an opportunity to impact clinical behavior on a large scale and potentially improve public health," said Christina Hoffman, MS, co-author and Group Vice President, Quality and Strategy, Medscape Education. "We were able to target clinicians who may have been compromising public health, reach them, and have a positive impact on their behavior, in addition to providing a large enough control group to measure change."

The publication can be found in the Jan-Mar 2020 issue of Pharmacy Practice or accessed online at http://doi.org/10.18549/PharmPract.2020.2.1773

    1. U.S. Food and Drug Administration, Drug Safety and Availability. FDA
       warns about increased risk of ruptures or tears in the aorta blood vessel
       with fluoroquinolone antibiotics in certain patients. Silver Spring (MD):
       U.S. Food and Drug Administration; Dec 20, 2018. Available from:
       https://www.fda.gov/Drugs/DrugSafety/ucm628753.htm (accessed Nov 4, 2019)
    2. Kabbani S, Hersh AL, Shapiro DJ, Fleming-Dutra KE, Pavia AT, Hicks LA.
       Opportunities to improve fluoroquinolone prescribing in the United States
       for adult ambulatory care visits. Clin Inf Dis. 2018;67(1):134-136.
       https://doi.org/10.1093/cid/ciy035

About Medscape Education

Medscape Education (medscape.org) is the leading destination for continuous professional development, consisting of more than 30 specialty-focused destinations offering thousands of free CME and CE courses and other educational programs for physicians, nurses, and other health care professionals. Medscape Education is part of WebMD Health Corp., an Internet Brands company.

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SOURCE Medscape