8.4 Unsuccessful case studies

Reducing antibiotic prescriptions for acute respiratory infections

Despite guidelines recommending against the use of antibiotics for most acute respiratory infections), overprescription remains a problem in many settings. This is largely due to interventions being solely focused on provider education without addressing patient expectations or system-level incentives (Barlam et al., 2016). This highlights the need for multifaceted approaches that include patient education, provider feedback mechanisms and potentially system-level changes to reduce the perceived need for prescribing.

Routine daily lab testing in hospitalised patients

Routine daily laboratory tests for hospitalised patients without specific indications represent a common low-value practice. Efforts to reduce this practice often face challenges related to ingrained routines and the perceived safety net of frequent testing (Eaton et al., 2017). Unsuccessful interventions have pointed to the need for strong leadership support, cultural change within institutions and mechanisms that make it easier to follow new protocols, such as changes to order sets in electronic health record systems.