Reducing Unnecessary Antibiotic Prescriptions in Primary Healthcare in Saskatchewan by Identifying High Prescribers
Study Details
Study Description
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.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Audit and Feedback Letter This group will receive 2 audit and feedback letters and a study closure letter. |
Behavioral: Audit 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.
|
| No Intervention: No Audit and Feedback Letter This group will only receive a study closure letter. |
Outcome Measures
Primary Outcome Measures
- Total Antibiotic Prescriptions [12 months]
Total number of antibiotic prescriptions compared to covariate-adjusted baseline number of prescriptions prior to the intervention.
Secondary Outcome Measures
- 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.
Eligibility Criteria
Criteria
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
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Saskatchewan Health Authority - Regina Area
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Leis JA, Born KB, Ostrow O, Moser A, Grill A. Prescriber-led practice changes that can bolster antimicrobial stewardship in community health care settings. Can Commun Dis Rep. 2020 Jan 2;46(1):1-5. doi: 10.14745/ccdr.v46i01a01. eCollection 2020 Jan 2.
- Schwartz KL, Langford BJ, Daneman N, Chen B, Brown KA, McIsaac W, Tu K, Candido E, Johnstone J, Leung V, Hwee J, Silverman M, Wu JHC, Garber G. Unnecessary antibiotic prescribing in a Canadian primary care setting: a descriptive analysis using routinely collected electronic medical record data. CMAJ Open. 2020 May 7;8(2):E360-E369. doi: 10.9778/cmajo.20190175. Print 2020 Apr-Jun.
- REB-22-38