Influencing prescribing in primary care: a comparison of two different prescribing feedback methods

This study evaluated two different methods of providing practice-based, antibiotic prescribing feedback to general practitioners (GPs). The impact of face-to-face prescribing discussion visits led by a pharmaceutical prescribing adviser were compared to the provision of practice specific prescribing analysis workbooks. Sixty-six practices within one Family Health Services Authority were randomly stratified into one of two groups (Group 1: visits; Group 2: workbooks). The 23 practices who did not wish to participate were used as a self selected control group (Group 3). Twelve months after the start of the programme, visits were extended to Group 2 and Group 3. Prescribing patterns were evaluated using five prescribing indicators, before and at 12 and 24 months after the start of the programme. Analysis of practice prescribing patterns at 12-months demonstrated that the desired changes in the selected five indicators were greater in Group 1 than Group 2 or Group 3; changes were statistically significant for indicators 5, 4 and 2 in each group, respectively. After 24 months all groups demonstrated significant changes in five indicators. Face-to-face visits proved the most successful of the two methods to influence GP prescribing, although the workbook promoted more change than that seen in the control group.