Electronic Prescription Data to Improve Primary Care Prescribing

Not Applicable

Completed

• Conditions: Physician's Practice Patterns

• Registration Number: NCT02512198
• Lead Sponsor: University of Dundee

Brief Summary

This is a randomised controlled study to evaluate the effect of providing prescribing feedback that includes individual patient data to General Practitioners (GP) in Scotland on high risk or low quality prescribing.

Detailed Description

This study makes use of data held in the Prescription Information System (PIS), the national database available to national health service (NHS) health boards in Scotland, on all prescriptions dispensed by community pharmacists which include the unique patient identifier for Scotland (CHI).

The design is a two parallel arm cluster randomised trial with general practices as the unit of randomisation to whom the feedback intervention is directed, and outcomes measured at patient level. Both arms receive the same active interventions but focused on different topics, with each acting as control to the other.

The primary outcome in the asthma arm is a composite of measure of potentially high-risk asthma prescribing (multiple short acting beta-agonists or single agent long acting beta-agonists both in the absence of inhaled corticosteroid therapy).

The primary outcome in the urinary tract infection antibiotic arm is a measure of repeated use of single (likely long-term prevention) or multiple (repeated treatment courses) urinary tract infection antibiotics.

Within the feedback, alongside the patient-level analysis, there will be action-orientated messages to guide the GP practice.

GP practices will get the reports three times at six-monthly intervals.

Study Timeline

• Study Start: 2015-07
• Study First Submitted: 2015-07-23
• Study First Submitted QC: 2015-07-28
• Study First Posted: 2015-07-30
• Primary Completion: 2017-01
• Study Completion: 2017-07-01
• Status Verified: 2021-05
• Last Update Submitted: 2021-05-20
• Last Update Posted: 2021-05-25

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 236

Inclusion Criteria

• GP practices in the participating Health Board area (NHS Greater Glasgow and Clyde)

Exclusion Criteria

• GP practices with registered list sizes <250 patients (all of these are unusual practices in various ways, for example serving the homeless or people with challenging behaviour).
• GP practices with <80% of prescriptions for inhaled bronchodilators and UTI antibiotics in the prescription database with a recorded patient identifier for each month from January 2014 to December 2014.
• GP practices which were created after 1 January 2015.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Number of people identified by the measures of high risk or low quality prescribing	12 months

Secondary Outcome Measures

Name	Time	Method
Cost-effectiveness of feedback	12 months	The economic evaluation will estimate costs and benefits using the cost perspective of the NHS, it will take account medicines cost, costs within the GP practice and use of other NHS services.

Trial Locations

Locations (1)

NHS Greater Glasgow and Clyde; 🇬🇧 Glasgow, United Kingdom