Op-058 Stemming The Tide Of Antibiotic Resistance: A Trial Of A Theory Based Intervention Addressing Appropriate Antibiotic Prescribing In Primary Care (The Star Programme)

Simpson S. (Cardiff), Butler C. (Cardiff), Hood K. (Cardiff), Rollnick S. (Cardiff), Cohen D. (Cardiff), Hare M. (Cardiff), Bekkers M.J. (Cardiff), Evans J. (Cardiff), Dunstan F. (Cardiff)
Introduction: There are still considerable further gains that could be made in reducing inappropriate antibiotic prescribing, but complex interventions are required. Studies to date have generally evaluated the effect of interventions on antibiotic prescribing in a single consultation and pragmatic evaluations that assess maintenance of new skills are rare. We have developed a Social Cognitive Theory based, blended learning intervention called the STAR Educational Program. The intervention involves use of practices’ own prescribing and resistance data and novel consulting strategies which aims to enhance antibiotic prescribing in primary care. The primary objective of the study is to assess whether exposing prescribers in General Practices to the STAR programme results in fewer antibiotics being dispensed to the patients in those practices over one year.
Methods: The study is a randomized controlled trial with general practice as the unit of randomization and analysis. Sixty-eight general practices across Wales were randomised in a way that balances for practice size, previous antibiotic prescribing, and proportion of GPs who signed up for the study. The study compared practices trained via the STAR programme with those not trained. Control practices were offered the intervention after the initial one year follow-up of the experimental practices was complete. The main analysis was intention to treat and compared the two groups for annual total antibiotics dispensed per 1000 practice patients within practices in the year following the intervention, using analysis of covariance with the average of the previous three years’ prescribing as a covariate.
Results and Conclusions: This trial will be the first to evaluate the effectiveness of an intervention involving a blended learning programme which focuses on both clinicians’ reflections on their prescribing habits and practice level data on prescribing and antimicrobial resistance, as well as an introduction to novel consulting strategies for use during consultations for common infections. This approach has the potential to improve communication between clinicians and patients, as well as reducing unnecessary antibiotic prescribing. The results of this study are currently being analysed by the team and will be complete by July.
Stemming the tide of antibiotic resistance: a trial of a theory based intervention addressing appropriate antibiotic prescribing in primary care (the STAR programme)