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

Upper Respiratory Tract Infections Clinical Trial

Official title:

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

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT05557214
• Other study ID #: REB-22-38
• Status: Withdrawn
• Phase: N/A
• Start date: May 2023
• Est. completion date: May 2024

Study information

• Verified date: April 2023
• Source: Saskatchewan Health Authority - Regina Area
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: May 2024
• Est. primary completion date: May 2024
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: N/A and older

Eligibility

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

Related Conditions & MeSH terms

• Respiratory Tract Infections
• Upper Respiratory Tract Infections

Intervention

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.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Saskatchewan Health Authority - Regina Area

References & 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. — View Citation

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. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Total Antibiotic Prescriptions	Total number of antibiotic prescriptions compared to covariate-adjusted baseline number of prescriptions prior to the intervention.	12 months
Secondary	Total Prolonged-Duration Prescription	Number of prescriptions longer than 7 days.	12 months
Secondary	Total Days of Therapy	Number of days of therapy of antimicrobials for each provider.	12 months
Secondary	Antibiotic Cost	Total cost of prescribed antibiotics.	12 months
Secondary	Total Specific Antibiotic Prescriptions	Number of prescriptions for specific antibiotics.	12 months