Letters to GPs show peer pressure can cut antibiotic prescribing rates

Individualised letters to GP practices giving feedback on their antibiotic prescribing habits could help cut unnecessary prescriptions of antibiotics, research has shown.

Letters sent to practices with the highest antibiotic prescribing rates helped them cut down by an average of 3.3% over six months, the Lancet study found.

The results suggest the scheme could help make a significant dent in the UK’s five-year target – from 2013 to 2018 – to reduce antibiotic prescribing in primary care by 4% to help tackle resistance to the drugs.

The researchers added that the intervention could help reduce England’s prescribing by 0.85% overall to aid in the fight against antimicrobial resistance.

The study, a nationwide trial involving over 1,500 GP practices, was led by a collaboration of CMO Professor Dame Sally Davies, Public Health England (PHE), the DH and the Behavioural Insights Team.

Antibiotics reduced

The researchers sent letters to practices across England who had antibiotic prescribing rates among the top 20% for their area.

A DH spokeswoman confirmed it has now sent out letters to all practices at the requisite prescribing levels.

Half of the practices were informed that their prescribing rates were high and suggested three simple methods to reduce them. The others were sent patient education materials such as posters and leaflets.

Those sent the former managed to cut their antibiotic items dispensed per 1,000 patients to 127, compared to 131 for those that did not – a 3.3% reduction. There was no significant difference to practices sent the patient education materials.

The letter overall led to over 73,000 fewer prescriptions across England, contributing to a saving of over £92,000 in prescription costs. The letters cost just 6p per prescription prevented.

Resistance threat

Dame Sally said: ‘We know that drug resistant infections are one of the biggest health threats we face.

‘This innovative trial has shown effective and low cost ways to reduce unnecessary prescribing of antibiotics which is essential if we are to preserve these precious medicines and help to save modern medicine as we know it.’

RCGP chairwoman Dr Maureen Baker warned that GPs come under ‘huge pressure’ to prescribe antibiotics.

‘We all have a responsibility to curb growing global resistance to antibiotics,’ she said. ‘GPs and other prescribers are constantly on the lookout for ways to reduce inappropriate antibiotics prescribing right across the NHS – and beyond, in sectors such as agriculture – and we are open to explore initiatives to help with this.

‘There is nothing to say that doctors who prescribe the most antibiotics are doing so inappropriately; some doctors will prescribe more than others simply as a result of the demographics of their patients.

‘Nevertheless, family doctors are open to feedback and welcome a reflective approach to prescribing – but what is really important is that we all work together to make the public realise that prescribing antibiotics is not always the answer to treating minor, self-limiting illness.’

Photo: iStock

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