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

April 11, 2023 updated by: Jason Vanstone, Saskatchewan Health Authority - Regina Area

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.

Study Overview

Status

Withdrawn

Conditions

Intervention / Treatment

Study Type

Interventional

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / 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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total Antibiotic Prescriptions
Time Frame: 12 months
Total number of antibiotic prescriptions compared to covariate-adjusted baseline number of prescriptions prior to the intervention.
12 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total Prolonged-Duration Prescription
Time Frame: 12 months
Number of prescriptions longer than 7 days.
12 months
Total Days of Therapy
Time Frame: 12 months
Number of days of therapy of antimicrobials for each provider.
12 months
Antibiotic Cost
Time Frame: 12 months
Total cost of prescribed antibiotics.
12 months
Total Specific Antibiotic Prescriptions
Time Frame: 12 months
Number of prescriptions for specific antibiotics.
12 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Saskatchewan Health Authority - Regina Area

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Anticipated)

May 1, 2023

Primary Completion (Anticipated)

May 1, 2024

Study Completion (Anticipated)

May 1, 2024

Study Registration Dates

First Submitted

September 22, 2022

First Submitted That Met QC Criteria

September 26, 2022

First Posted (Actual)

September 27, 2022

Study Record Updates

Last Update Posted (Actual)

April 13, 2023

Last Update Submitted That Met QC Criteria

April 11, 2023

Last Verified

April 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REB-22-38

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Deidentified aggregate data will be shared via a published manuscript at the conclusion of the study.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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