Provision of social-norms feedback to general practices whose antibiotic prescribing is increasing: a national randomized controlled trial

Gold, Natalie ORCID: 0000-0003-0706-1618, Ratajczak, Michael, Sallis, Anna, Saei, Ayoub, Watson, Robin, van Schaik, Paul, Bowen, Sarah and Chadborn, Tim (2022) Provision of social-norms feedback to general practices whose antibiotic prescribing is increasing: a national randomized controlled trial. Journal of Public Health, 30 (10). 2351 - 2358. ISSN 1741-3842

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Abstract

Aim: The Chief Medical Officer of England writes an annual social-norms-feedback letter to the highest antibiotic-prescribing GP practices. We investigated whether sending a social-norms-feedback letter to practices whose prescribing was increasing would reduce prescribing. Subject and methods: We conducted a two-armed randomised controlled trial amongst practices whose STAR-PU-adjusted prescribing was in the 20th–95th percentiles and had increased by > 4% year-on-year in the 2 previous financial years. Intervention practices received a letter on 1st March 2018 stating ‘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%.’. Control practices received no letter. The primary outcome was the STAR-PU-adjusted rate of antibiotic prescribing in the months from March to September 2018. Results: We randomly assigned 930 practices; ten closed or merged pre-trial, leaving 920 practices — 448 in the intervention and 472 in the control. An autoregressive and moving average model of first order ARMA(1,1) correlation structure showed no effect of the intervention (β < −0.01, z = −0.50, p = 0.565). Prescribing reduced over time in both arms (β < −0.01, z = −36.36, p < 0.001). Conclusions: A social-norms-feedback letter to practices whose prescribing was increasing did not decrease prescribing compared to no letter. Trial registration: NCT03582072.

Item Type:	Article
Official URL:	https://www.springer.com/journal/10389
Additional Information:	© 2021 The Authors
Divisions:	CPNSS
Subjects:	R Medicine > RA Public aspects of medicine
Date Deposited:	22 Sep 2021 15:33
Last Modified:	12 Dec 2024 02:40
URI:	http://eprints.lse.ac.uk/id/eprint/111973

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