Feedback Program for Reducing Antibiotic Overprescription

This trial aims to determine if an educational program can reduce unnecessary antibiotic prescriptions by family doctors and nurse practitioners in British Columbia, Canada. The program, called the "Prescribing Portrait Audit and Feedback," provides a personalized prescribing "portrait" and a summary of evidence on appropriate antibiotic use. Researchers will compare two groups: one receives the program early, and the other receives it nine months later. The trial seeks healthcare providers who prescribed over 100 medications in 2024 and are registered with the BC Medical Services Plan. As an unphased trial, this study offers a unique opportunity to improve healthcare practices and reduce antibiotic misuse.

The trial does not specify whether participants need to stop taking their current medications. It focuses on reducing unnecessary antibiotic prescriptions by healthcare providers, not on patient medication changes.

Research has shown that audit and feedback methods, such as the prescribing portrait, are generally safe in healthcare settings. These methods provide healthcare providers with personalized information about their prescribing habits to aid improvement. Studies have not identified any direct harm to patients or providers from these methods. Specifically, a large review involving 45.5 million years of follow-up found no safety issues related to these methods.

Researchers are excited about the Feedback Program for Reducing Antibiotic Overprescription because it focuses on changing clinician behavior through an innovative audit-and-feedback method. Unlike traditional approaches that often involve guidelines or education sessions, this program provides personalized feedback by using prescribing portraits and evidence summaries. This method aims to directly address overprescription by giving clinicians a clear view of their prescribing habits compared to best practices, potentially leading to more responsible antibiotic use.

Research has shown that giving feedback to healthcare professionals can help reduce the overuse of antibiotics. For instance, studies have found that this approach can lead to an 11% decrease in the amount of antibiotics prescribed. In this trial, the Early Group of clinicians will receive the prescribing portrait audit-and-feedback intervention at the study's initiation, while the Delayed Control group will receive it approximately 9 months later. This method provides doctors with information about their prescribing habits, aiding them in making better choices. The feedback compares their prescribing patterns to recommended guidelines. This type of intervention has successfully improved antibiotic prescribing and reduced unnecessary use.¹²⁵⁶⁷