Skip to main content

Research Repository

Advanced Search

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

Gold, Natalie; Ratajczak, Michael; Sallis, Anna; Saei, Ayoub; Watson, Robin; van Schaik, Paul; Bowen, Sarah; Chadborn, Tim

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


Authors

Natalie Gold

Michael Ratajczak

Anna Sallis

Ayoub Saei

Robin Watson robin.o.watson@durham.ac.uk
PGR Student Doctor of Philosophy

Paul van Schaik

Sarah Bowen

Tim Chadborn



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.

Citation

Gold, N., Ratajczak, M., Sallis, A., Saei, A., Watson, R., van Schaik, P., …Chadborn, T. (2022). Provision of social-norms feedback to general practices whose antibiotic prescribing is increasing: a national randomized controlled trial. Journal of Public Health, 30, 2351-2358. https://doi.org/10.1007/s10389-021-01645-4

Journal Article Type Article
Acceptance Date Aug 13, 2021
Online Publication Date Dec 27, 2021
Publication Date 2022
Deposit Date Feb 16, 2022
Publicly Available Date Feb 17, 2022
Journal Journal of Public Health
Print ISSN 0943-1853
Electronic ISSN 1613-2238
Publisher Springer
Peer Reviewed Peer Reviewed
Volume 30
Pages 2351-2358
DOI https://doi.org/10.1007/s10389-021-01645-4

Files

Published Journal Article (624 Kb)
PDF

Publisher Licence URL
http://creativecommons.org/licenses/by/4.0/

Copyright Statement
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.






You might also like



Downloadable Citations