The Effectiveness of Small Group Education on Improving Antibiotic Prescribing in General Practice: A Mixed Methods Systematic Review.

Background/Objectives: Reducing inappropriate use of antimicrobial agents in healthcare settings is a critical strategy to mitigate the growing threat of antimicrobial resistance. Globally, the highest consumption of antimicrobials in human healthcare originates from antibiotic prescriptions made in General Practice settings. Small group learning has long held a key role in General Practice education, characterized by active participation, common learning goals, and opportunities for reflection. This mode of delivery has been explored as a potential approach to increase appropriate antibiotic prescribing, supported by research indicating that more didactic educational interventions are unlikely to effectively improve physician prescribing behaviours. This systematic review specifically sought to synthesise the evidence on the effectiveness of small group-based, interventions in improving appropriate antibiotic prescribing behaviours in general practice. Methods: A mixed methods systematic review was employed. Studies were eligible if they reported on in-person, small group-based educational interventions to improve antibiotic prescribing among GPs. Full-text screening resulted in 19 eligible studies. Key characteristics, such as study design, intervention content, and outcomes, were extracted. Results: The 19 included studies used single and multi-modal interventions, with 68% focusing on respiratory tract infections. Common topics were patient communication (n = 11) and adherence to prescribing guidelines (n = 8). Most (n = 11) reported positive outcomes like reduced prescribing and were acceptable to GPs. Conclusions: These types of interventions can be effective in increasing the appropriate use of antibiotics in General Practice and are well received by GP participants. However, further research is required on the optimal content delivered in interventions and their associated long-term impact.