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Completed

NCT Number: NCT03862794

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

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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Key information

Conditions

Prescribing, Off-Label

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Public Health England

London, SE1, United Kingdom

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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).

Exclusion criteria

  • none

Treatment and study plan

new social norm feedback letter with bar chart

Behavioral

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

standard social norm feedback letter

Behavioral

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

Primary outcomes

  1. total antibiotic prescribing weighted by Specific Therapeutic group Age-sex Related Prescribing Unit (STAR-PU) in November for each GP practice

    Time frame: 1 month

    antibiotic prescribing weighted by Specific Therapeutic group Age-sex Related Prescribing Unit (STAR-PU)

  2. total broad spectrum antibiotic prescribing weighted by STAR-PU in November for each GP practice

    Time frame: 1 month

    broad spectrum antibiotic prescribing weighted by Specific Therapeutic group Age-sex Related Prescribing Unit (STAR-PU)

  3. percentage broad spectrum antibiotic prescribing in November for each GP practice

    Time frame: 1 month

    percentage broad spectrum antibiotic prescribing

  4. total non-broad spectrum antibiotic prescribing weighted by STAR-PU in November for each GP practice

    Time frame: 1 month

    total overall antibiotic prescribing minus total broad spectrum antibiotic prescribing

  5. total antibiotic prescribing weighted by STAR-PU in December for each GP practice

    Time frame: 2 months

    antibiotic prescribing weighted by Specific Therapeutic group Age-sex Related Prescribing Unit (STAR-PU)

  6. total broad spectrum antibiotic prescribing weighted by STAR-PU in December for each GP practice

    Time frame: 2 months

  7. percentage broad spectrum antibiotic prescribing in December for each GP practice

    Time frame: 2 months

  8. total non-broad spectrum antibiotic prescribing weighted by STAR-PU in December for each GP practice

    Time frame: 2 months

  9. total antibiotic prescribing in January weighted by STAR-PU for each GP practice

    Time frame: 3 months

  10. total broad spectrum antibiotic prescribing weighted by STAR-PU in January for each GP practice

    Time frame: 3 months

  11. percentage broad spectrum antibiotic prescribing in January for each GP practice

    Time frame: 3 months

  12. total non-broad spectrum antibiotic prescribing weighted by STAR-PU in January for each GP practice

    Time frame: 3 months

  13. total antibiotic prescribing weighted by STAR-PU in February for each GP practice

    Time frame: 4 months

  14. total broad spectrum antibiotic prescribing weighted by STAR-PU in February for each GP practice

    Time frame: 4 months

  15. percentage broad spectrum antibiotic prescribing in February for each GP practice

    Time frame: 4 months

  16. total non-broad spectrum antibiotic prescribing weighted by STAR-PU in February for each GP practice

    Time frame: 4 months

  17. total antibiotic prescribing weighted by STAR-PU in March for each GP practice

    Time frame: 5 months

  18. total broad spectrum antibiotic prescribing weighted by STAR-PU in March for each GP practice

    Time frame: 5 months

  19. percentage broad spectrum antibiotic prescribing in March for each GP practice

    Time frame: 5 months

  20. total non-broad spectrum antibiotic prescribing weighted by STAR-PU in March for each GP practice

    Time frame: 5 months

  21. total antibiotic prescribing weighted by STAR-PU in April for each GP practice

    Time frame: 6 months

  22. total broad spectrum antibiotic prescribing weighted by STAR-PU in April for each GP practice

    Time frame: 6 months

  23. percentage broad spectrum antibiotic prescribing in April for each GP practice

    Time frame: 6 months

  24. total non-broad spectrum antibiotic prescribing weighted by STAR-PU in April for each GP practice

    Time frame: 6 months

Sponsors and collaborators

Lead sponsor

Public Health England

Other Gov

Registry information

Official study title

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

Acronym: CMO2018-9

Important dates

Study start
2018
Primary completion
2019
Study completion
2019
First posted
Mar 5, 2019
Registry last updated
Mar 3, 2020

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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