Imperial College London
Alternate

Dr Céire Costelloe

Faculty of Medicine, School of Public Health

Visiting Professor
 
 
 
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Contact

 

+44 (0)20 7594 0799ceire.costelloe

 
 
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Location

 

326Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Anyanwu:2020:10.3399/bjgpopen20X101052,
author = {Anyanwu, PE and Pouwels, K and Walker, A and Moore, M and Majeed, A and Hayhoe, BWJ and Tonkin-Crine, S and Borek, A and Hopkins, S and Mcleod, M and Costelloe, C},
doi = {10.3399/bjgpopen20X101052},
journal = {BJGP Open},
pages = {1--12},
title = {Investigating the mechanism of impact and differential effect of the Quality Premium scheme on antibiotic prescribing in England: a longitudinal study},
url = {http://dx.doi.org/10.3399/bjgpopen20X101052},
volume = {4},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: In 2017, approximately 73% of antibiotics in England were prescribed from primary care practices. It has been estimated that 9%-23% of antibiotic prescriptions between 2013 and 2015 were inappropriate. Reducing antibiotic prescribing in primary care was included as one of the national priorities in a financial incentive scheme in 2015-2016. AIM: To investigate whether the effects of the Quality Premium (QP), which provided performance-related financial incentives to clinical commissioning groups (CCGs), could be explained by practice characteristics that contribute to variations in antibiotic prescribing. DESIGN & SETTING: Longitudinal monthly prescribing data were analysed for 6251 primary care practices in England from April 2014 to March 2016. METHOD: Linear generalised estimating equations models were fitted, examining the effect of the 2015-2016 QP on the number of antibiotic items per specific therapeutic group age-sex related prescribing unit (STAR-PU) prescribed, adjusting for seasonality and months since implementation. Consistency of effects after further adjustment for variations in practice characteristics were also examined, including practice workforce, comorbidities prevalence, prescribing rates of non-antibiotic drugs, and deprivation. RESULTS: Antibiotics prescribed in primary care practices in England reduced by -0.172 items per STAR-PU (95% confidence interval [CI] = -0.180 to -0.171) after 2015-2016 QP implementation, with slight increases in the months following April 2015 (+0.014 items per STAR-PU; 95% CI = +0.013 to +0.014). Adjusting the model for practice characteristics, the immediate and month-on-month effects following implementation remained consistent, with slight attenuation in immediate reduction from -0.172 to -0.166 items per STAR-PU. In subgroup analysis, the QP effect was significantly greater among the top 20% prescribing practices (interaction p<0.001). Practices with low workforce and those with higher diabet
AU  - Anyanwu,PE
AU  - Pouwels,K
AU  - Walker,A
AU  - Moore,M
AU  - Majeed,A
AU  - Hayhoe,BWJ
AU  - Tonkin-Crine,S
AU  - Borek,A
AU  - Hopkins,S
AU  - Mcleod,M
AU  - Costelloe,C
DO  - 10.3399/bjgpopen20X101052
EP  - 12
PY  - 2020///
SN  - 2398-3795
SP  - 1
TI  - Investigating the mechanism of impact and differential effect of the Quality Premium scheme on antibiotic prescribing in England: a longitudinal study
T2  - BJGP Open
UR  - http://dx.doi.org/10.3399/bjgpopen20X101052
UR  - https://www.ncbi.nlm.nih.gov/pubmed/32665235
UR  - https://bjgpopen.org/content/4/3/bjgpopen20X101052
UR  - http://hdl.handle.net/10044/1/77988
VL  - 4
ER  -
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