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
Mr Robin Watson firstname.lastname@example.org
Paul van Schaik
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.
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|
|Deposit Date||Feb 16, 2022|
|Publicly Available Date||Feb 17, 2022|
|Journal||Journal of Public Health|
|Peer Reviewed||Peer Reviewed|
Published Journal Article
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