Upper Respiratory Tract Infections
Conditions
Keywords
audit and feedback, antimicrobials, primary healthcare
Brief summary
Approximately 90% of antibiotics are prescribed in primary healthcare (PHC) in Canada (Public Health Agency of Canada, 2020), making this an important sector for antimicrobial stewardship. Upper respiratory tract infections (URTIs) represent a common indication in PHC for which antibiotics are often prescribed unnecessarily (Leis et al, 2020; Schwartz et al., 2020). Reducing unnecessary antibiotic treatment in this sector is a vital part of contributing to minimizing the global burden of antibiotic resistance. The goal of this research project is to reduce the number of antibiotic prescriptions among family physicians identified as high prescribers in Saskatchewan. To achieve this, the investigators will send letters to the top 25th percentile of high prescribers in PHC. The letters will contain data indicating the prescribers high antimicrobial usage as well as guidance for reducing unnecessary prescriptions and promoting appropriate lengths of prescriptions for upper respiratory tract infections.
Interventions
BEHAVIORALAudit and Feedback Letter
Physicians in the Audit and Feedback Letter Arm will receive an initial letter indicating their high prescriber status with guidance on reducing unnecessary antimicrobial use. They will also receive a follow-up letter at the 6 month mark indicating any change in prescribing habits. There will be a study closure letter mailed at the 12 month mark.
Sponsors
Saskatchewan Health Authority - Regina Area
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* must be a practicing family physician in Saskatchewan * top 25th percentile of antimicrobial prescribers
Exclusion criteria
* fewer than 12 months of historical prescribing data available
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total Antibiotic Prescriptions | 12 months | Total number of antibiotic prescriptions compared to covariate-adjusted baseline number of prescriptions prior to the intervention. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total Prolonged-Duration Prescription | 12 months | Number of prescriptions longer than 7 days. |
| Total Days of Therapy | 12 months | Number of days of therapy of antimicrobials for each provider. |
| Antibiotic Cost | 12 months | Total cost of prescribed antibiotics. |
| Total Specific Antibiotic Prescriptions | 12 months | Number of prescriptions for specific antibiotics. |
Outcome results
None listed