• Giorgio Costantino, Ludovico Furlan, Christian Bracco, Maria Domenica Cappellini, Giovanni Casazza, Vanessa Nunziata, Chiara Beatrice Cogliati, Anna Fracanzani, Raffaello Furlan, Giovanni Gambassi, Roberto Manetti, Raffaele Manna, Alfonso Piccoli, PignoneAlberto MoggiAMDipartimento Assistenziale Integrato di Emergenza ed Accettazione, Azienda Ospedaliera-Universitaria careggi, Firenze, Italy., GianMarco Podda, Teresa Salvatore, Stefania Sella, Alessandro Squizzato, Moreno Tresoldi, Francesco Perticone, Antonello Pietrangelo, Gino Roberto Corazza, and Nicola Montano.
• Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy; Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milano, Italy.
• Eur. J. Intern. Med. 2021 Nov 1; 93: 71-77.

ObjectivesTo evaluate the impact of an educational intervention based on the Italian Society of Internal Medicine Choosing Wisely (CW-SIMI) recommendations.DesignMulticenter, interventional, controlled study.SettingTwenty-three acute-care hospital wards in Italy.Participants303 Physicians working in internal medicine wards.InterventionAn online educational course.Main OutcomesThe rate of proton pump inhibitor (PPI) prescriptions, the number of days of central venous catheter (CVC) usage, and the duration of intravenous (IV) antibiotic prescriptions evaluated at one month (T1) and at six months (T2) after course completion. Patients admitted and discharged during a 30-day period before the educational intervention (T0, one year before T2) were considered the comparison group.ResultsA total of 232 physicians completed the course, while 71 did not attend the course. Data from 608, 662, and 555 patients were analyzed at T0, T1, and T2, respectively. The rate of PPI prescriptions declined at one month (RR: 0.67, 95% CI: 0.52-0.87, p = 0.0005) and at six months (RR: 0.62, 95% CI: 0.46-0.84, p = 0.003), and the number of days of CVC usage was reduced at six months (9.13 days at T0 vs. 5.52 days at T2, p = 0.007). The duration of IV antibiotic prescriptions displayed a decreasing trend (7.94 days at T0 vs. 7.42 days at T2, p = 0.081).ConclusionsA simple online educational intervention based on the CW-SIMI recommendations was associated with a clinically relevant reduction in the usage of PPIs and CVCs. Further studies are needed to confirm these findings and a possible benefit on patients' outcomes.Copyright © 2021. Published by Elsevier B.V.

14 keywords...

hide…