A Randomized Controlled Trial of Behaviourally Informed Feedback Letters Sent by the Chief Medical Officer on the Amount of Antibiotics and the Percentage of Broad Spectrum Antibiotics Prescribed in Primary Care
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 7,000
- 试验地点
- 1
- 主要终点
- total antibiotic prescribing weighted by Specific Therapeutic group Age-sex Related Prescribing Unit (STAR-PU) in November for each GP practice
研究概览
简要总结
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •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).
排除标准
- 未提供
研究组 & 干预措施
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
干预措施: new social norm feedback letter with bar chart (Behavioral)
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
干预措施: standard social norm feedback letter (Behavioral)
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
干预措施: new social norm feedback letter with bar chart (Behavioral)
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
干预措施: standard social norm feedback letter (Behavioral)
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
干预措施: new social norm feedback letter with bar chart (Behavioral)
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.
结局指标
主要结局
total antibiotic prescribing weighted by Specific Therapeutic group Age-sex Related Prescribing Unit (STAR-PU) in November for each GP practice
时间窗: 1 month
antibiotic prescribing weighted by Specific Therapeutic group Age-sex Related Prescribing Unit (STAR-PU)
total non-broad spectrum antibiotic prescribing weighted by STAR-PU in December for each GP practice
时间窗: 2 months
percentage broad spectrum antibiotic prescribing in January for each GP practice
时间窗: 3 months
total broad spectrum antibiotic prescribing weighted by STAR-PU in November for each GP practice
时间窗: 1 month
broad spectrum antibiotic prescribing weighted by Specific Therapeutic group Age-sex Related Prescribing Unit (STAR-PU)
percentage broad spectrum antibiotic prescribing in November for each GP practice
时间窗: 1 month
percentage broad spectrum antibiotic prescribing
total non-broad spectrum antibiotic prescribing weighted by STAR-PU in November for each GP practice
时间窗: 1 month
total overall antibiotic prescribing minus total broad spectrum antibiotic prescribing
total antibiotic prescribing weighted by STAR-PU in December for each GP practice
时间窗: 2 months
antibiotic prescribing weighted by Specific Therapeutic group Age-sex Related Prescribing Unit (STAR-PU)
total broad spectrum antibiotic prescribing weighted by STAR-PU in December for each GP practice
时间窗: 2 months
percentage broad spectrum antibiotic prescribing in December for each GP practice
时间窗: 2 months
total antibiotic prescribing weighted by STAR-PU in February for each GP practice
时间窗: 4 months
total non-broad spectrum antibiotic prescribing weighted by STAR-PU in February for each GP practice
时间窗: 4 months
total broad spectrum antibiotic prescribing weighted by STAR-PU in January for each GP practice
时间窗: 3 months
total broad spectrum antibiotic prescribing weighted by STAR-PU in February for each GP practice
时间窗: 4 months
percentage broad spectrum antibiotic prescribing in February for each GP practice
时间窗: 4 months
total antibiotic prescribing weighted by STAR-PU in March for each GP practice
时间窗: 5 months
total antibiotic prescribing in January weighted by STAR-PU for each GP practice
时间窗: 3 months
total non-broad spectrum antibiotic prescribing weighted by STAR-PU in January for each GP practice
时间窗: 3 months
percentage broad spectrum antibiotic prescribing in April for each GP practice
时间窗: 6 months
total broad spectrum antibiotic prescribing weighted by STAR-PU in March for each GP practice
时间窗: 5 months
percentage broad spectrum antibiotic prescribing in March for each GP practice
时间窗: 5 months
total non-broad spectrum antibiotic prescribing weighted by STAR-PU in March for each GP practice
时间窗: 5 months
total antibiotic prescribing weighted by STAR-PU in April for each GP practice
时间窗: 6 months
total broad spectrum antibiotic prescribing weighted by STAR-PU in April for each GP practice
时间窗: 6 months
total non-broad spectrum antibiotic prescribing weighted by STAR-PU in April for each GP practice
时间窗: 6 months
次要结局
未报告次要终点