Antibiotic resistance Infections and Infestations
Conditions
Interventions
1,500 GP practices with high antibiotic prescribing rates are randomly allocated into one of two treatment arms:
1. Experiment arm: a letter designed with behavioural science techniques and sent to al
Sponsors
Public Health England (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. GP practices in England who issued prescriptions in May 2014, according to HSCIC prescribing data (the latest data available at the time of design) 2. GP practices whose antibiotic prescribing rate is in the top 20% for their NHS Local Area, controlling for relevant patient characteristics. More specifically, we will apply the Health and Social Care Information Centre's STARPU weightings for oral antibiotics (BNF 5.1 subset). These consist of age and gender weightings.
Exclusion criteria
Exclusion criteria: 1. 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, since figures above this level were considered to be the result of measurement error. This judgment was made based on medical advice. 2. We exclude practices that have been in operation for less than a year in September 2014, since we require data for September 2013 in order to apply the difference-in-differences analysis.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Our primary outcome measure is a comparison of the change in the antibiotic prescribing rate from September to October 2014 between treatment and control groups, controlling for changes between these two months experienced by GP practices in previous years. | — |
Secondary
| Measure | Time frame |
|---|---|
| We will look at prescription rates for specific classes of antibiotics used to treat upper respiratory tract infections: pencillins, macrolides, Coamoxiclav, tetracyclines. This analysis will include looking at changes in the number of doses of specific types antibiotics generally prescribed for upper respiratory tract infections per 1,000 registered patients and whether the intervention has a stronger or weaker effect depending on the location, age, and gender of the recipients. We will compare changes in the antibiotic prescribing rate from September to October 2014 controlling for changes in prescribing between the same two months in 2013 ? as there is a three-month lag in the publication of the data, we will receive the data to the end of October 2014 in January. | — |
Countries
United Kingdom
Outcome results
None listed