Evidence map›Paper›PMID 40001106›Full record

Trial reportBMC health services research2025

Educational interventions delivered to prescribing advisers to influence primary care prescribing: a very low-cost pragmatic randomised trial using routine data from OpenPrescribing.net.

Helen J Curtis, Brian MacKenna, Bhavana Reddy, Alex J Walker, Sebastian Bacon, Rafael Perera, Ben Goldacre

Abstract readPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

7 authors.

Helen J Curtis *Nuffield Department of Primary Care Health Sciences, The Bennett Institute for Applied Data Science, University of Oxford, Oxford, OX2 6GG, UK. helen.curtis@phc.ox.ac.uk.
Brian MacKenna *Nuffield Department of Primary Care Health Sciences, The Bennett Institute for Applied Data Science, University of Oxford, Oxford, OX2 6GG, UK. brian.mackenna@phc.ox.ac.uk.
Bhavana ReddyNHS England, 80 London Road, London, SE1 6LH, England.
Alex J WalkerNuffield Department of Primary Care Health Sciences, The Bennett Institute for Applied Data Science, University of Oxford, Oxford, OX2 6GG, UK.
Sebastian BaconNuffield Department of Primary Care Health Sciences, The Bennett Institute for Applied Data Science, University of Oxford, Oxford, OX2 6GG, UK.
Rafael PereraNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK.
Ben GoldacreNuffield Department of Primary Care Health Sciences, The Bennett Institute for Applied Data Science, University of Oxford, Oxford, OX2 6GG, UK.

Funding

Health Foundation Award Reference Number 7599National Institute for Health Research (NIHR) Research for Patient Benefit (RfPB) Programme Grant Reference Number PB-PG-0418-20036National Institute for Health Research (NIHR) School of Primary Care Research (SPCR) Award Reference Number 327
6 · The paper itself

Abstract

backgroundNHS England issued commissioning guidance on 18 low-priority treatments which should not be routinely prescribed in primary care. We aimed to monitor the impact of an educational intervention delivered to regional prescribing advisors by senior pharmacists from NHS England on the primary care spend on low-priority items.

methodsAn opportunistic randomised, controlled parallel-group trial. Participants (clinical commissioning groups, CCGs) were randomised to intervention or control in a 1:1 ratio. The intervention group were invited to participate. The intervention was a one-off educational session. Our primary outcomes concerned the total prescribing of low-priority items in primary care. Secondary outcomes concerned the prescribing of specific low-priority items. We also measured the impact on information-seeking behaviour.

results40 CCGs were randomised, 20 allocated to intervention, with 11 receiving the intervention. There was no significant impact on any prescribing outcomes. There was some possible evidence of increased engagement with data, in the form of CCG email alert sign-ups (p = 0.077). No harms were detected.

conclusionsA one-off intervention delivered to CCGs by NHS England did not significantly influence low-priority prescribing. This trial demonstrates how routine interventions planned to improve uptake or adherence to healthcare guidance can be delivered as low-cost randomised trials and how to robustly assess their effectiveness.

trial registrationISRCTN31218900, October 01 2018.

Indexed as

Drug PrescriptionsPractice Patterns, Physicians'Primary Health CareEnglandHumansState MedicineCost-effectivenessEducationGeneral practicePrescribingRandomised controlled trial

Identifiers

PMID40001106
PMCPMC11854403

What OpenQuestion holds

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Registered trials

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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.