CMO Letter to Reduce Unnecessary Antibiotic Prescribing and Broad Spectrum Prescribing Winter 2018-9

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

7000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-11-01

Study Completion Date

2019-05-30

Brief Summary

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This trial aims to reduce unnecessary prescription of antibiotics and broad spectrum 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 the sample was GPs whose practices whose prescribed more than 1.161 items per STAR-PU or whose practices prescribed more that .965 items per STAR-PU and greater than 10% broad spectrum items. The intervention groups received a letter telling them they are among the highest prescribers of either their total or broad spectrum antibiotics, with a graph showing their prescribing compared to average prescribing ("their peers"). The letter also contained 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.

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Detailed Description

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Conditions

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Prescribing, Off-Label

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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high total and high broad spectrum prescribing letter

social norm feedback letter with bar chart GPs who prescribe more than 1.161 Antibacterial Items/ STAR-PU and more than 10% broad spectrum receive a letter that has specific information about the percentile they are on for broad spectrum prescribing and a bar chart representing their broad spectrum prescribing compared to the average

Group Type EXPERIMENTAL

new social norm feedback letter with bar chart

Intervention Type BEHAVIORAL

letter with the percentile prescribing the practice is on and a bar chart, comparing prescribing to the national average

high total and high broad spectrum prescribing control

standard social norm feedback letter GPs who prescribe more than 1.161 Antibacterial Items/ STAR-PU and more than 10% broad spectrum receive the standard practice overall prescribing letter as a control

Group Type ACTIVE_COMPARATOR

standard social norm feedback letter

Intervention Type BEHAVIORAL

social norm feedback letter used as standard practice, without specific information about the prescribing percentile

high total prescribing only intervention letter

social norm feedback letter with bar chart GPs who prescribe more than 1.161 Antibacterial Items/ STAR-PU and less than 10% broad spectrum receive a letter that has specific information about the percentile they are on for overall prescribing and a bar chart representing their overall prescribing compared to the average

Group Type EXPERIMENTAL

new social norm feedback letter with bar chart

Intervention Type BEHAVIORAL

letter with the percentile prescribing the practice is on and a bar chart, comparing prescribing to the national average

high total prescribing control letter

standard social norm feedback letter GPs who prescribe more than 1.161 Antibacterial Items/ STAR-PU and less than 10% broad spectrum receive the standard practice overall prescribing letter as a control

Group Type ACTIVE_COMPARATOR

standard social norm feedback letter

Intervention Type BEHAVIORAL

social norm feedback letter used as standard practice, without specific information about the prescribing percentile

moderate total prescribing and high broad spectrum letter

social norm feedback letter with bar chart GPs who prescribe more than 0.965 but less than 1.161 Antibacterial Items/ STAR-PU and more than 10% broad spectrum will receive a letter that has specific information about the percentile they are on for broad spectrum prescribing and a bar chart representing their broad spectrum prescribing compared to the average

Group Type EXPERIMENTAL

new social norm feedback letter with bar chart

Intervention Type BEHAVIORAL

letter with the percentile prescribing the practice is on and a bar chart, comparing prescribing to the national average

moderate total prescribing and high broad spectrum control

GPs who prescribe more than 0.965 but less than 1.161 Antibacterial Items/ STAR-PU and more than 10% broad spectrum receive no letter, which is standard practice, as a control.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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new social norm feedback letter with bar chart

letter with the percentile prescribing the practice is on and a bar chart, comparing prescribing to the national average

Intervention Type BEHAVIORAL

standard social norm feedback letter

social norm feedback letter used as standard practice, without specific information about the prescribing percentile

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* GP practices that prescribed more than 1.161 Antibacterial Items/STAR-PU for the twelve months (June 2017 - May 2018)
* GP practices that prescribed more than 0.965 Antibacterial Items/STAR-PU and also more than 10% broad spectrum items for the twelve months (June 2017 - May 2018).