PMID- 34353705
OWN - NLM
STAT- MEDLINE
DCOM- 20211208
LR  - 20211214
IS  - 1879-0828 (Electronic)
IS  - 0953-6205 (Linking)
VI  - 93
DP  - 2021 Nov
TI  - Impact of implementing a Choosing Wisely educational intervention into clinical 
      practice: The CW-SIMI study (a multicenter-controlled study).
PG  - 71-77
LID - S0953-6205(21)00250-8 [pii]
LID - 10.1016/j.ejim.2021.07.008 [doi]
AB  - OBJECTIVES: To evaluate the impact of an educational intervention based on the 
      Italian Society of Internal Medicine Choosing Wisely (CW-SIMI) recommendations. 
      DESIGN: Multicenter, interventional, controlled study. SETTING: Twenty-three 
      acute-care hospital wards in Italy. PARTICIPANTS: 303 Physicians working in 
      internal medicine wards. INTERVENTION: An online educational course. MAIN 
      OUTCOMES: The 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. RESULTS: A 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). CONCLUSIONS: A 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.
CI  - Copyright (c) 2021. Published by Elsevier B.V.
FAU - Costantino, Giorgio
AU  - Costantino G
AD  - Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy; 
      Dipartimento di Scienze Cliniche e di Comunita, Universita degli Studi di Milano, 
      Milano, Italy.
FAU - Furlan, Ludovico
AU  - Furlan L
AD  - Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy.
FAU - Bracco, Christian
AU  - Bracco C
AD  - Medicina Interna, A.O. Santa Croce e Carle di Cuneo, Italy.
FAU - Cappellini, Maria Domenica
AU  - Cappellini MD
AD  - Dipartimento di Scienze Cliniche e di Comunita, Universita degli Studi di Milano, 
      Milano, Italy.
FAU - Casazza, Giovanni
AU  - Casazza G
AD  - Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Universita degli Studi 
      di Milano, Milano, Italy.
FAU - Nunziata, Vanessa
AU  - Nunziata V
AD  - Dipartimento di Scienze Cliniche e di Comunita, Universita degli Studi di Milano, 
      Milano, Italy.
FAU - Cogliati, Chiara Beatrice
AU  - Cogliati CB
AD  - Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Universita degli Studi 
      di Milano, Milano, Italy.
FAU - Fracanzani, Anna
AU  - Fracanzani A
AD  - Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy; 
      Medicina Interna a indirizzo fisiopatologico, ASST Fatebenefratelli Sacco, 
      Milano, Italy.
FAU - Furlan, Raffaello
AU  - Furlan R
AD  - Humanitas Clinical and Research Center-IRCCS. Dept of Biomedical 
      Sciences-Humanitas University, Rozzano, Italy.
FAU - Gambassi, Giovanni
AU  - Gambassi G
AD  - Humanitas Clinical and Research Center-IRCCS. Dept of Biomedical 
      Sciences-Humanitas University, Rozzano, Italy; Fondazione Policlinico 
      Universitario Agostino Gemelli, IRCCS, Universita Cattolica del Sacro Cuore, 
      Roma, Italy.
FAU - Manetti, Roberto
AU  - Manetti R
AD  - Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, Universita degli 
      Studi di Sassari, Sassari, Italy.
FAU - Manna, Raffaele
AU  - Manna R
AD  - Institute of Internal Medicine, Periodic Fever and Rare Diseases Research Centre, 
      Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.
FAU - Piccoli, Alfonso
AU  - Piccoli A
AD  - Medicina Interna, Istituto Clinico San Rocco di Istituti Ospedalieri Bresciani 
      GSD, Italy.
FAU - Pignone, Alberto Moggi
AU  - Pignone AM
AD  - Dipartimento Assistenziale Integrato di Emergenza ed Accettazione, Azienda 
      Ospedaliera-Universitaria careggi, Firenze, Italy.
FAU - Podda, GianMarco
AU  - Podda G
AD  - Medicina III, San Paolo, ASST Santi Paolo e Carlo, Dipartimento di Scienza della 
      Salute, Universita degli Studi di Milano, Milano, Italy.
FAU - Salvatore, Teresa
AU  - Salvatore T
AD  - UOC di Medicina Interna, Azienda Ospedaliera dell'Universita degli Studi Luigi 
      Vanvitelli, Napoli, Italy.
FAU - Sella, Stefania
AU  - Sella S
AD  - Dipartimento di Medicina, Clinica Medica 1, Universita degli Studi di Padova, 
      Padova, Italy.
FAU - Squizzato, Alessandro
AU  - Squizzato A
AD  - Universita degli Studi dell'Insubria, Varese, Italy.
FAU - Tresoldi, Moreno
AU  - Tresoldi M
AD  - Medicina Generale e delle Cure Avanzate IRCCS Ospedale San Raffaele, Milan, 
      Italy.
FAU - Perticone, Francesco
AU  - Perticone F
AD  - Universita Magna Grecia di Catanzaro, Catanzaro, Italy.
FAU - Pietrangelo, Antonello
AU  - Pietrangelo A
AD  - Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, 
      Universita degli Studi di Modena e Reggio Emilia, Italy.
FAU - Corazza, Gino Roberto
AU  - Corazza GR
AD  - Dipartimento di Medicina Interna e Terapia Medica, Universita degli Studi di 
      Pavia, Pavia, Italy.
FAU - Montano, Nicola
AU  - Montano N
AD  - Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy; 
      Dipartimento di Scienze Cliniche e di Comunita, Universita degli Studi di Milano, 
      Milano, Italy. Electronic address: nicola.montano@unimi.it.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20210802
PL  - Netherlands
TA  - Eur J Intern Med
JT  - European journal of internal medicine
JID - 9003220
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Administration, Intravenous
MH  - *Anti-Bacterial Agents/therapeutic use
MH  - Humans
MH  - Internal Medicine
MH  - Italy
MH  - *Proton Pump Inhibitors/therapeutic use
OTO - NOTNLM
OT  - Antibiotics
OT  - Appropriateness
OT  - Choosing wisely
OT  - Cvc
OT  - Less is more
OT  - Proton pump inhibitors
EDAT- 2021/08/07 06:00
MHDA- 2021/12/15 06:00
CRDT- 2021/08/06 05:46
PHST- 2021/03/14 00:00 [received]
PHST- 2021/06/28 00:00 [revised]
PHST- 2021/07/16 00:00 [accepted]
PHST- 2021/08/07 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2021/08/06 05:46 [entrez]
AID - S0953-6205(21)00250-8 [pii]
AID - 10.1016/j.ejim.2021.07.008 [doi]
PST - ppublish
SO  - Eur J Intern Med. 2021 Nov;93:71-77. doi: 10.1016/j.ejim.2021.07.008. Epub 2021 
      Aug 2.