British Columbia Prescriber Feedback Program - Antimicrobial Resistance

Summary

The goal of this study is to evaluate an educational intervention that aims to reduce the number of unnecessary antibiotics prescribed by family physicians and nurse practitioners in British Columbia, Canada.

The intervention materials include a confidential personalized prescribing "portrait" and an evidence-based educational summary (therapeutics letter), accompanied by an introduction letter.

The main research questions are:

1. Will the intervention lead to a reduction in the overall number of antibiotics prescriptions started?
2. Will the intervention lead to a reduction in the proportion of antibiotics prescribed that are likely unnecessary, especially prescriptions for upper respiratory tract infections, acute bronchitis, acute sinusitis?

Researchers will conduct an intervention study with family physicians and nurse practitioners in British Columbia, Canada. Participant clinicians will be randomly assigned to one of two groups. The Early Group will consist of 80% of the participants and will receive the intervention (prescribing portrait, evidence summary, and introduction letter) at the start of the study. The Delayed Group will consist of 20% of participants and will receive the intervention about nine months later. This study design allows most practitioners to receive the intervention early while still allowing time to compare the two groups to assess the impact. To estimate the impact of the intervention, researchers will use administrative health data to compare the prescribing of the Early Group with prescribing of the Delayed Group.

Conditions

• Quality Improvement
• Feedback
• Prescribing
• Antibiotics
• Antimicrobial Drug Resistance

Interventions

BEHAVIORAL

Prescribing portrait audit and feedback

The prescribing portrait audit-and-feedback intervention consists of a confidential, personalized prescribing audit-and-feedback report (Portrait), an evidence-based educational summary (therapeutics letter), and an introduction letter. The prescribing portrait uses linked BC Ministry of Health administrative claims data and presents two key recommendations: (1) reduce the proportion of patient visits resulting in an antibiotic prescription, and (2) avoid routinely prescribing antibiotics for upper respiratory tract infections, acute bronchitis, and acute sinusitis. Each recommendation is accompanied by a bar graph showing the prescriber's 2024 performance compared with the median prescriber in British Columbia and an achievable target. The intervention will be delivered using a secure paper mailing process. During every aspect of production and delivery, prescribing data are confidential and protected.

Sponsors & Collaborators

• Ministry of Health, British Columbia

  collaborator OTHER_GOV

• British Columbia Centre for Disease Control

  collaborator OTHER_GOV

• University of British Columbia

  lead OTHER

Principal Investigators

• Colin Dormuth, ScD · University of British Columbia

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

SEQUENTIAL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-02-17

Primary Completion

2026-11-30

Completion

2028-11-30

Countries

• Canada

Study Locations