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Feedback improves practice antibiotic prescribing levels

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Giving clinicians feedback on their prescribing habits could help reduce the excessive use of antibiotics and other drugs, according to a new study.

A nationwide trial involving more than 1,500 GP practices in England with the highest antibiotic prescribing rates found writing to surgeries led to fewer prescriptions and savings of more than £92,000 over six months.

“This kind of feedback could also be provided for many other kind of drugs”

Michael Hallsworth

On average, GPs who got the letter, which flagged up their performance and gave tips on reducing unnecessary antibiotic prescriptions, cut prescribing by 3.3% over the trial period, reveal the findings published in The Lancet.

The trial was a collaboration between England’s chief medical officer, Public Health England, the Department of Health and the Behavioural Insights Team – or Nudge Unit - formerly part of government but now a “social purpose company” jointly owned by the Cabinet Office.

The study compared the effectiveness of two different approaches targeting 1,581 practices with antibiotic prescribing rates in the top 20% for their area.

Practices were randomly selected to receive the letter or posters and leaflets aimed at patients.

GPs who got the letter reduced their rate of antibiotic items prescribed per 1,000 population to 126.98, compared to 131.24 for those who did not get the letter.

The difference equals 3.3% – adding up to more than 73,400 fewer antibiotic items dispensed.

In contrast, the patient education material did not appear to have a significant impact on prescribing rates.

The research team highlighted the low cost of sending a letter – at just 6p per prescription saved – and said the approach could help with targets to reduce primary care prescribing.

Sally Davies

Sally Davies

Sally Davies

“Giving tailored feedback to prescribers isn’t complicated,” said lead author Michael Hallsworth from the Behavioural Insights Team. “This kind of feedback could also be provided for many other kind of drugs.”

In response, CMO for England Professor Dame Sally Davies said: ”We know that drug resistant infections are one of the biggest health threats we face.

”This innovative trial has shown effective and low cost ways to reduce unnecessary prescribing of antibiotics, which is essential if we are to preserve these precious medicines and help to save modern medicine as we know it,” she said.

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