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Image shows baton transfer to represent an intervention
Why and how to delegate works

Interventions

A restrictive strategy uses interventions that either prevent or provide a ‘barrier’ to prescribing or administering an antibiotic.

Restrictive interventions are more effective than educational interventions in the short-term, but are not more effective long-term.

A persuasive strategy uses interventions that attempt to persuade healthcare professionals to prescribe appropriately by addressing underlying knowledge deficiencies and/or attitudes and/or behaviours.

Persuasive interventions are less effective than restrictive interventions in the short-term, but are as effective in the long-term. The difference between restrictive and persuasive strategies is summarised in the figure below.

Interventions can also be structural. For example, the hospital-wide introduction of rapid diagnostic technology in the laboratory or computerised clinical decision support. In real-life, often a combination of the above strategies will be employed.

This figure is a graph with the y axis which represents difference in effect size and ranges from minus 100% to 100%.  The x axis represents time since intervention and shows 1, 6, 12 and 24 months after intervention.  Meta‐regression of the difference in effect size between restrictive and persuasive interventions at 1, 6, 12 and 24 months after the intervention. The difference is restrictive minus persuasive, so positive values for the difference indicate greater effect size for restrictive interventions and negative values indicate greater effect size for persuasive interventions. The bars show the 95% confidence interval for the mean difference.

Meta‐regression of the difference in effect size between restrictive and persuasive interventions at 1, 6, 12 and 24 months after the intervention. The difference is restrictive minus persuasive, so positive values for the difference indicate greater effect size for restrictive interventions and negative values indicate greater effect size for persuasive interventions. The bars show the 95% confidence interval for the mean difference.

For more information please go to the Cochrane Review.

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This article is from the free online course:

Antimicrobial Stewardship: Managing Antibiotic Resistance

University of Dundee