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 Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
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.
Total Antibiotic Prescriptions
Total number of antibiotic prescriptions compared to covariate-adjusted baseline number of prescriptions prior to the intervention.
Time frame: 12 months
Total Prolonged-Duration Prescription
Number of prescriptions longer than 7 days.
Time frame: 12 months
Total Days of Therapy
Number of days of therapy of antimicrobials for each provider.
Time frame: 12 months
Antibiotic Cost
Total cost of prescribed antibiotics.
Time frame: 12 months
Total Specific Antibiotic Prescriptions
Number of prescriptions for specific antibiotics.
Time frame: 12 months
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