Provision of social-norms feedback to general practices whose antibiotic prescribing is increasing: a national randomized controlled trial
Provision of social-norms feedback to general practices whose antibiotic prescribing is increasing: a national randomized controlled trial
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向抗生素处方不断增加的全科医生提供社会规范反馈：一项全国随机对照试验
DOI：
10.1007/s10389-021-01645-4
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发表时间：
2021
影响因子：
4.4
通讯作者：
Gold N
中科院分区：
文献类型：
--
作者：
Gold N
目标英格兰首席医疗官每年都会向抗生素处方最高的全科医生写一封社会规范反馈信。我们调查了向处方增加的诊所发送社会规范反馈信是否会减少处方。主题和方法我们在 STAR-PU 调整后的处方处于第 20-95 个百分位数且在前 2 个财政年度同比增加超过 4% 的诊所中进行了一项双臂随机对照试验。干预诊所于 2018 年 3 月 1 日收到一封信，信中指出“英格兰绝大多数 (80%) 诊所在 2016/17 年减少或稳定了抗生素处方率。然而，您的诊所是少数将处方增加超过 4% 的诊所。”控制措施没有收到任何信件。主要结果是 2018 年 3 月至 9 月期间经 STAR-PU 调整的抗生素处方率。结果我们随机分配了 930 名医生； 10 处已结束或合并预审，留下 920 处诊所，其中 448 处为干预处，472 处为对照处。一阶 ARMA(1,1) 相关结构的自回归和移动平均模型显示干预没有影响 (β< −0.01, z= −0.50,p= 0.565)。两组的处方随着时间的推移而减少（β< −0.01，z= −36.36，p< 0.001）。结论与没有信件相比，给处方增加的诊所的社会规范反馈信并没有减少处方。试验注册NCT03582072。
AimThe Chief Medical Officer of England writes an annual social-norms-feedback letter to the highest antibiotic-prescribing GP practices. We investigated whether sending a social-norms-feedback letter to practices whose prescribing was increasing would reduce prescribing.Subject and methodsWe conducted a two-armed randomised controlled trial amongst practices whose STAR-PU-adjusted prescribing was in the 20th–95th percentiles and had increased by > 4% year-on-year in the 2 previous financial years. Intervention practices received a letter on 1st March 2018 stating ‘The great majority (80%) of practices in England reduced or stabilised their antibiotic prescribing rates in 2016/17. However, your practice is in the minority that have increased their prescribing by more than 4%.’. Control practices received no letter. The primary outcome was the STAR-PU-adjusted rate of antibiotic prescribing in the months from March to September 2018.ResultsWe randomly assigned 930 practices; ten closed or merged pre-trial, leaving 920 practices — 448 in the intervention and 472 in the control. An autoregressive and moving average model of first order ARMA(1,1) correlation structure showed no effect of the intervention (β< −0.01, z= −0.50,p= 0.565). Prescribing reduced over time in both arms (β< −0.01, z= −36.36,p< 0.001).ConclusionsA social-norms-feedback letter to practices whose prescribing was increasing did not decrease prescribing compared to no letter.Trial registrationNCT03582072.
影响因子：
3.8
作者：
Dempsey RC;McAlaney J;Bewick BM
通讯作者：
Bewick BM
野外规范：如何诊断、衡量和改变社会规范
DOI：
10.1215/00318108-6972726
发表时间：
2018
期刊：
The Philosophical Review
影响因子：
--
作者：
Bryce Huebner
通讯作者：
Bryce Huebner
有说服力的信息对国家卫生服务器官捐献者登记的影响：一项针对 100 万英国道路纳税人的务实的准随机对照试验
影响因子：
2.5
作者：
A. Sallis;Hugo Harper;Michael Sanders
通讯作者：
Michael Sanders