Feedback of antibiotic prescribing to primary care
| ISRCTN | ISRCTN70810031 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN70810031 |
| Secondary identifying numbers | 1.0 |
- Submission date
- 06/05/2016
- Registration date
- 23/06/2016
- Last edited
- 25/05/2021
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English summary of protocol
Background and study aims
Antibiotics are vital for treatment of bacterial infections. The main driver for development of antimicrobial resistance is exposure to antibiotics and resistance is greatest where use is greatest. Resistance is a natural consequence of using antibiotics but overuse and inappropriate use can unnecessarily increase the rate of resistance development.
The aim of this study is to test whether e-mail feedback of a practices antibiotic prescribing together with action orientated goal setting information can reduce antibiotic prescribing.
Who can participate?
General practices in NHS Ayrshire & Arran, NHS Highland, NHS Lanarkshire and NHS Lothian.
What does the study involve?
Participating general practices are randomly allocated to one of two groups. Those in the first group receive quarterly reports for a year containing information about the amount of antibiotics they are prescribing compared to a benchmark for their NHS board and Scotland as a whole. The report also contains suggested actions that practices can take and details of the support resources that are available. Those in the second group continue with their usual practice and do not receive any reports. One year after the final report, the rate of prescribing antibiotics in general and to different age groups, as well as the rate of prescribing different antibiotics in all the practices is recorded.
What are the possible benefits and risks of participating?
Practices in the feedback arm will benefit from having access to reports containing the amount of antibiotics they are prescribing. There are no notable risks involved with participating in this study.
Where is the study run from?
The study is run from NHS National Services Scotland and takes place in 183 general practices in Scotland (UK)
When is study starting and how long is it expected to run for?
August 2015 to June 2017
Who is the main contact?
William Malcolm
w.malcolm@nhs.net
Contact information
Scientific
NHS National Services Scotland
4th Floor, Meridian Court
5 Cadogan Street
Glasgow
G2 6QE
United Kingdom
| Phone | +44 (0)141 300 1174 |
|---|---|
| w.malcolm@nhs.net |
Study information
| Study design | Interventional cluster randomised controlled study |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Cluster randomised trial |
| Study setting(s) | GP practice |
| Study type | Other |
| Scientific title | Feedback of Antibiotic Prescribing to Primary Care (FAPPC): A cluster randomised controlled trial using nationally held prescribing data |
| Study acronym | FAPPC |
| Study objectives | A report containing feedback of antibiotic prescribing data plus action orientated goal setting text delivered by email to primary care medical practices will reduce antibiotic prescribing compared to practices which do not receive the reports. |
| Ethics approval(s) | Ethical approval was not required as the study is an assessment of the impact of a service development using nationally held prescribing data and no patient identifiable information provided. |
| Health condition(s) or problem(s) studied | Antibiotic prescribing in primary care |
| Intervention | The intervention is feedback of antibiotic prescribing data plus action orientated goal setting text Practices in the feedback arm will receive quarterly feedback of practice rates of antibiotic prescribing compared to a benchmark of the 25th percentile at local and national together with suggested actions that practices can take and details of the support resources that are available. Comparators will receive usual care (no report) |
| Intervention type | Other |
| Primary outcome measure | Rate of prescribing of systemic antibacterials is calculated as the number of antibacterial prescriptions per 1000 registered patients per day measured one year after the final intervention. |
| Secondary outcome measures | 1. Number of antibacterials defined daily doses per 1000 registered patients per day measured 1 year after the final intervention 2. Number of antibacterial prescriptions per 1000 registered patients aged 0-4 years per day measured 1 year after the final intervention 3. Number of antibacterial prescriptions per 1000 registered patients aged 5-64 years per day measured 1 year after the final intervention 4. Number of antibacterial prescriptions per 1000 registered patients aged ≥65 years per day measured 1 year after the final intervention 5. Number of amoxicillin prescriptions per 1000 registered patients per day measured 1 year after the final intervention 6. Number of phenoxymethylpenicillin prescriptions per 1000 registered patients per day measured 1 year after the final intervention 7. Number of flucloxacillin prescriptions per 1000 registered patients per day measured 1 year after the final intervention 8. Number of co-amoxiclav prescriptions per 1000 registered patients per day measured 1 year after the final intervention 9. Number of doxycycline prescriptions per 1000 registered patients per day measured 1 year after the final intervention 10. Number of clarithromycin and erythromycin prescriptions per 1000 registered patients per day measured 1 year after the final intervention 11. Number of trimethoprim prescriptions per 1000 registered patients per day measured 1 year after the final intervention 12. Number of nitrofurantoin prescriptions per 1000 registered patients per day measured 1 year after the final intervention 13. Number of ciprofloxacin prescriptions per 1000 registered patients per day measured 1 year after the final intervention 14. Number of cefalexin prescriptions per 1000 registered patients per day measured 1 year after the final intervention 15. Number of prescriptions commonly used for respiratory tract infections (amoxicillin, doxycycline, phenoxymethylpencillin) per 1000 registered patients per day measured 1 year after the final intervention 16. Number of prescriptions commonly used for urinary tract infections (trimethoprim, nitrofurantoin, ciprofloxacin, cefalexin, co-amoxiclav) per 1000 registered patients per day measured 1 year after the final intervention 17. Number of prescriptions commonly used for long term skin infections (oxytetratcycline, lymecycline, minocycline ) per 1000 registered patients per day measured 1 year after the final intervention 18. Number of hospital admissions with mastoiditis, peritonsillar abscess, pneumonia, exacerbation of COPD |
| Overall study start date | 01/08/2015 |
| Completion date | 30/06/2017 |
Eligibility
| Participant type(s) | Health professional |
|---|---|
| Age group | All |
| Sex | Both |
| Target number of participants | Number of practices enrolled 183 |
| Key inclusion criteria | General medical practices in NHS Ayrshire and Arran, NHS Highland, NHS Lanarkshire and NHS Lothian. |
| Key exclusion criteria | 1. Practices with <250 registered patients 2. Practices which cease to exist during the trial 3. Practices which merge with another practice where the merging practices are in different arms |
| Date of first enrolment | 01/04/2015 |
| Date of final enrolment | 01/04/2015 |
Locations
Countries of recruitment
- Scotland
- United Kingdom
Study participating centre
United Kingdom
Sponsor information
Other
Gyle Square
Edinburgh
EH12 9EB
United Kingdom
"ROR" |
https://ror.org/04za2st18 |
|---|
Funders
Funder type
Government
No information available
Results and Publications
| Intention to publish date | 30/06/2018 |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Not provided at time of registration |
| Publication and dissemination plan | Not provided at time of registration. |
| IPD sharing plan |
Editorial Notes
25/05/2021: Proactive update review. No publications found. Search options exhausted.
18/10/2017: Internal review.
