Evidence map›Paper›PMID 36172861›Full record

Trial reportThe Journal of antimicrobial chemotherapy2022

Feedback of Antibiotic Prescribing in Primary Care (FAPPC) trial: results of a real-world cluster randomized controlled trial in Scotland, UK.

Charis A Marwick, Anower Hossain, Rita Nogueira, Jacqueline Sneddon, Kim Kavanagh, Marion Bennie, R Andrew Seaton, Bruce Guthrie, William Malcolm

Open access · hybridAbstract readRandomized Controlled TrialPragmatic Clinical Trial
In one paragraph

Trial report in The Journal of antimicrobial chemotherapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.6field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 2 countries.

Charis A MarwickPopulation Health & Genomics Division, School of Medicine, University of Dundee, Dundee, UK.
Anower HossainInstitute of Statistical Research and Training, University of Dhaka, Dhaka-1000, Bangladesh.
Rita NogueiraPublic Health Scotland, Edinburgh, UK.
Jacqueline SneddonScottish Antimicrobial Prescribing Group, Healthcare Improvement Scotland, Glasgow, UK.
Kim KavanaghDepartment of Mathematics and Statistics, University of Strathclyde, Glasgow, UK.
Marion BenniePublic Health Scotland, Edinburgh, UK.ORCID 0000-0002-4046-629X
R Andrew SeatonScottish Antimicrobial Prescribing Group, Healthcare Improvement Scotland, Glasgow, UK.ORCID 0000-0002-2509-0597
Bruce GuthrieUsher Institute, University of Edinburgh, Edinburgh, UK.ORCID 0000-0003-4191-4880
William MalcolmARHAI (Antimicrobial Resistance and Healthcare Associated Infection) Scotland, NHS National Services Scotland, Glasgow, UK.
Healthcare Improvement Scotland · GBUniversity of Strathclyde · GBNational Health Service Scotland · GBPublic Health Scotland · GBUniversity of Dhaka · BDUniversity of Dundee · GBUniversity of Edinburgh · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the effect of general practice-level prescribing feedback on antibiotic prescribing in a real-world pragmatic cluster randomized controlled trial.

methodsThree hundred and forty general practices in four territorial Health Boards in NHS Scotland were randomized in Quarter 1, 2016 to receive four quarterly antibiotic-prescribing feedback reports or not, from Quarter 2, 2016 to Quarter 1, 2017. Reports included different clinical topics, benchmarking against national and health board rates, and behavioural messaging with improvement actions. The primary outcome was total antibiotic prescribing rate. There were 16 secondary prescribing outcomes and 5 hospital admission outcomes (potential adverse effects of reduced prescribing). The main evaluation timepoint was 1 year after the final report (Quarter 1, 2018), with an additional evaluation in the quarter after the final report (Quarter 2, 2017). Routine administrative NHS data were used to generate the feedback reports and analyse the effects.

resultsTotal antibiotic prescribing rates were lower at the main evaluation timepoint in both intervention (1.83 versus baseline 1.93 prescriptions/1000 patients/day) and control (1.90 versus baseline 1.98) practices, with no evidence of intervention effect [adjusted rate ratio (ARR) 0.98 (95% CI 0.94-1.02; P = 0.35)]. At the additional timepoint, adjusted total antibiotic prescribing rates were 1.67 and 1.73 prescriptions/1000 patients/day, with evidence of a small intervention effect, ARR 0.99 (0.98-1.00; P = 0.03).

conclusionsThis well-designed, practice-level antibiotic-prescribing feedback had limited evidence of additional effects in the context of decreasing antibiotic prescribing and an established national stewardship programme.

Indexed as

Anti-Bacterial AgentsGeneral PracticeFeedbackHumansInappropriate PrescribingPractice Patterns, Physicians'Primary Health CareScotlandAnti-Bacterial Agents

Identifiers

PMID36172861
PMCPMC9704438
OpenAlexW4297964916

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.