Reducing Unnecessary Antibiotic Prescriptions in Primary Healthcare in Saskatchewan by Identifying High Prescribers

NCT05557214 | Withdrawn

• 1 other identifier: REB-22-38
• Study Type: interventional
• Target: N/A
• Locations: 0 countries
• Sites: N/A

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.

Conditions

Upper Respiratory Tract Infections

Keywords

audit and feedback; antimicrobials; primary healthcare

Outcome Measures

Primary Outcomes (1)

• Total Antibiotic Prescriptions

  Total number of antibiotic prescriptions compared to covariate-adjusted baseline number of prescriptions prior to the intervention.

  12 months

Secondary Outcomes (4)

• Total Prolonged-Duration Prescription

  12 months

• Total Days of Therapy

  12 months

• Antibiotic Cost

  12 months

• Total Specific Antibiotic Prescriptions

  12 months

Study Arms (2)

Audit and Feedback Letter

EXPERIMENTAL

This group will receive 2 audit and feedback letters and a study closure letter.

Behavioral: Audit and Feedback Letter

No Audit and Feedback Letter

NO INTERVENTION

This group will only receive a study closure letter.

Interventions

Audit and Feedback Letter BEHAVIORAL

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.

Audit and Feedback Letter

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• must be a practicing family physician in Saskatchewan
• top 25th percentile of antimicrobial prescribers

You may not qualify if:

• fewer than 12 months of historical prescribing data available

Sponsors & Collaborators

• Saskatchewan Health Authority - Regina Area: lead

Related Publications (2)

• 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.

  PMID: 31930218 BACKGROUND

• 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.

  PMID: 32381687 BACKGROUND

MeSH Terms

Conditions

Respiratory Tract Infections

Condition Hierarchy (Ancestors)

Infections; Respiratory Tract Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Scientist

Study Record Dates

• First Submitted: September 22, 2022
• First Posted: September 27, 2022
• Study Start: May 1, 2023
• Primary Completion: May 1, 2024
• Study Completion: May 1, 2024
• Last Updated: April 13, 2023

Record last verified: 2023-04

Data Sharing

• IPD Sharing: Will not share