Give GPs feedback on prescribing habits to reduce antibiotic use, says study
pharmafile | February 18, 2016 | News story | Medical Communications, Research and Development | antimicrobial resistance
A trial of more than 1,500 GP practices has shown that sending general practitioners (GPs) letters giving feedback on their antibiotic prescribing habits could cut unnecessary prescriptions of antibiotics, and help tackle the growing threat of antimicrobial resistance.
Results of the first nationwide randomised trial of its kind, published in The Lancet journal, reveal that giving written feedback to GPs with the highest antibiotic prescribing rates cut prescribing by an average of 3.3% over six months. The letter led to more than 73,000 fewer prescriptions, and direct savings of over £92,000 in prescription costs over the course of the trial period.
The trial was a collaboration between England’s chief medical officer, Public Health England, the Department of Health, and the Behavioural Insights Team; the latter of which believes the use of behavioural science can help GPs alter their prescribing habits.
Overuse of antibiotics, which is most prevalent in primary care prescribing, has contributed to the development of increased resistance to such drugs, and a growing recognition of the problem has led the UK to set a five-year target (to 2018) of reducing antibiotic prescribing in primary care by 4%.
There are fears that, in a worst-case scenario, antimicrobial resistance could cause even routine surgery to become impossible, as the risk of patients contracting infections both during and after procedures could not be combatted by the use of antibiotics. This danger has led the medical community to take action through such schemes as charity campaigns to raise awareness of the issue, and encouraging the development of new antibiotics.
“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,” says Professor Dame Sally Davies, chief medical officer for England.
Between 2000 and 2014, UK primary-care antibiotic use expanded by 46%, from 14.3 to 20.9 defined daily doses per 1000 inhabitant days. During the same period, antibiotic use fell in several other European countries, to the point where UK consumption is now twice as high of that in the Netherlands.
“Giving tailored feedback to prescribers isn’t complicated,” adds the study’s lead author, Michael Hallsworth, from the Behavioural Insights Team, London, UK. “We estimate that this simple intervention could reduce England’s antibiotic prescribing by 0.85% overall, despite costing just 6p per prescription saved. This kind of feedback could also be provided for many other kinds of drugs, and by anyone who is interested in doing so, since all this information is publicly available online.”
The researchers assessed two mail-based interventions, targeting 1,581 practices across England who had antibiotic prescribing rates in the top 20% for their area. In one half of the trial, they sent GPs a letter, signed by the chief medical officer, saying “80% of practices in their local area prescribe fewer antibiotics per head than yours”, and providing three simple ways to ensure prescriptions were necessary. The second half of the trial tested the effect of a posters and leaflet-based educational campaign, targeted at patients at GP surgeries, promoting reduced use of antibiotics.
Over six months in winter 2014-2015, randomly-selected GPs who received the feedback letter cut their rate of antibiotic items dispensed per 1,000 population to 126.98, compared to 131.24 for those who did not receive the letter: representing a 3.3% fall, equivalent to 73,406 fewer antibiotic items dispensed. The letters were found to be an effective but inexpensive way of reducing antibiotic prescriptions, making a clear case for a broader implementation of such ‘behavioural’ approaches into the fight against antimicrobial and antibiotic resistance.
Joel Levy
Related Content
EpiEndo publishes new data supporting glasmacinal’s potential in COPD
EpiEndo Pharmaceuticals has announced the publication of three peer-reviewed articles in Pulmonary Pharmacology and Therapeutics, …
Glox Therapeutics Awarded £1M PACE Grant to Accelerate Development of Precision Antibiotics Against Antimicrobial-resistant Pathogens
Novel therapeutics to address unmet clinical need for pneumonias caused by drug-resistant Escherichia coli and …
European Parliament shares goal to tackle antimicrobial resistance
The European Parliament has shared its recommendations for a “coordinated EU response to health threats …
