Mailed Feedback And Antibiotic Prescribing In Older Adults

Key Takeaways:

• Investigators evaluated mailed feedback to primary care physicians in a pragmatic randomized trial focused on antibiotic prescribing.
• The reported population was adults aged 65 years and older in outpatient primary care.
• The study reported reductions in antibiotic prescribing rates following the intervention, with detailed outcome measures provided.

The report frames the question around outpatient antibiotic prescribing among patients aged 65 years and older, in routine primary care rather than inpatient or specialty settings. The available details describe an older outpatient population and a physician-directed intervention.

The investigators describe the design as a pragmatic factorial randomized controlled trial centered on mailed feedback to primary care physicians, with outpatient antibiotic prescribing rates in primary care as the measured outcome domain. The study reports numerical findings, including reductions in prescribing rates in the intervention group compared with control, along with effect estimates and confidence intervals.

The reported population consists of primary care physicians in Ontario, Canada, with outcomes measured based on their antibiotic prescribing to patients aged 65 years and older. The report notes a setting where outpatient antibiotic prescribing can be tracked within routine ambulatory practice, placing the study in everyday physician encounters rather than acute or procedural environments. The population description narrows the scope to older adults without extending beyond the information provided.

The authors report that antibiotic prescribing rates were lower in the intervention group compared with the control group at six months, with consistent findings at 12 months. Additional outcomes, including unnecessary prescribing, prolonged-duration prescriptions, and broad-spectrum antibiotic use, were also reduced in the intervention group. The study further reports that harms-focused messaging did not significantly affect prescribing, and case-mix adjustment showed no benefit.

These findings allow both the study question and the magnitude and direction of effect to be characterized from the reported results.