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Completed

NCT Number: NCT03582072

CMO Letter to Reduce Unnecessary Antibiotic Prescribing March 2018

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.

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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

About this study

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).

Who can participate

Healthy volunteers accepted: No

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

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.

Treatment and study plan

letter from the CMO

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%.*

Primary outcomes

  1. antibiotic prescribing in March

    Time frame: 1 month

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

  2. antibiotic prescribing in April

    Time frame: 2 months

    antibiotic prescribing weighted by STAR-PU

  3. antibiotic prescribing May-September

    Time frame: 3-7 months

    antibiotic prescribing weighted by STAR-PU

Sponsors and collaborators

Lead sponsor

Public Health England

Other Gov

Registry information

Official study title

Contacting GPs to Reduce Unnecessary Prescriptions of Antibiotics

Important dates

Study start
2018
Primary completion
2018
Study completion
2018
First posted
Jul 10, 2018
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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