CMO Letter to Reduce Unnecessary Antibiotic Prescribing March 2018

NCT ID: NCT03582072

Last Updated: 2020-03-03

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 4796 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-02-27
• Study Completion Date: 2018-12-31

Brief Summary

This trial aims to reduce unnecessary prescription of antibiotics by general practitioners (GPs) in England. Unnecessary prescriptions are defined as those that do not improve patient health outcomes. The intervention is to send GPs a letter from the Chief Medical Officer (CMO) that gives feedback on their practice's prescribing levels. Specifically, GPs in practices whose prescribing has increase by more than 4% over the past year will receive a letter stating that "The great majority (80%) of practices in England reduced or stabilised their antibiotic prescribing rates in 2016/17. However, your practice is in the minority that have increased their prescribing by more than 4%." The letter will also contain a leaflet to help GPs discuss self-care advice with patients and some advice to use delayed prescriptions. The investigators hypothesize that the antibiotic prescribing rate in will be lower for the treatment group compared to the control group, following the receipt of the letter.

Detailed Description

The investigators hypothesize that the antibiotic prescribing rate in will be lower for the treatment group compared to the control group; the statistical analysis will compare prescribing in March, April, and over the summer (treating May-September as a single data point).

Conditions

Prescribing, Off-Label

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: NONE

Study Groups

letter

letter from the CMO: practice outside the top 20% of prescribers whose prescribing increased by \> 4%, where GPs in the practice were sent a letter informing them their prescribing had increased

Group Type: EXPERIMENTAL

letter from the CMO

Intervention Type: BEHAVIORAL

informed GPs that: The great majority (80%) of practices in England reduced or stabilised their antibiotic prescribing rates in 2016/17. However, your practice is in the minority that have increased their prescribing by more than 4%.\*

control

practice outside of the top 20% of prescribers whose prescribing increase by \>4%, GPs were not sent a letter

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

letter from the CMO

informed GPs that: The great majority (80%) of practices in England reduced or stabilised their antibiotic prescribing rates in 2016/17. However, your practice is in the minority that have increased their prescribing by more than 4%.\*

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• GP practices that increased the number of prescriptions in the financial year 2016/17, compared to the baseline of financial year 2015/16, by 4% or more

Exclusion Criteria

• GP practices are excluded if their current level of prescription (doses per 1000 head of population) is classed as an outlier. The cut off for outliers is made at the 95th percentile of the distribution.
• Practices that have not been open since at least October 2013 will be excluded. This is because they will lack the historical data necessary to apply a control for seasonal effects to the main outcome variable.
• practices whose antibiotic prescribing rate is in the top 20% for their National Health Service (NHS) Local Area, controlling for relevant patient characteristics.

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Public Health England

OTHER_GOV

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Public Health England

London, , United Kingdom

Countries

United Kingdom

Other Identifiers

CMO letter March 2018

Identifier Type: -

Identifier Source: org_study_id