Lowering AntiMicrobial Prescribing (LAMP) – was a feedback intervention in primary care successful in reducing antibiotic prescribing in West Yorkshire?

Conference:

2021 SAPC North (virtual)

Talk Code:

1B.2

Presenter:

ES Lau

Co-authors:

Authors: Lau, E. S. W1, Kong, K. K. 1, Alderson, S.1,2, Wood, S.1,2 Co-Authors: Carder, P.2, Johnson, S. 2

Author institutions:

1. School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom 2. West Yorkshire Research & Development Team

Background

Antimicrobial resistance (AMR) has become a global health crisis as infections caused by antibiotic-resistant bacteria are challenging to treat [1]. AMR claims over 12,000 lives each year in the UK alone [2]. Furthermore, over 80% of antibiotic prescribing derives from primary care [3]. Thus, the Lowering AntiMicrobial Prescribing (LAMP) feedback intervention targeted towards primary care was implemented from April 2019 to April 2020 to curb AMR. Respective data on antibiotic prescribing were sent bimonthly to 288 general practices (GPs) across West Yorkshire via emailed PDF.

Approach

Retrospective service evaluation of a clinical audit was performed to determine the effectiveness of the feedback intervention. Prescribing data from April 2016 to April 2020 on total antibiotics, Amoxicillin, Co-Amoxiclav, Nitrofurantoin, Penicillin V and Tetracycline from GPs across West Yorkshire were collected from OpenPrescribing.com and compared with the same data from 187 GPs in South Yorkshire represent the control group. Data for each antibiotic were then tabulated into several graphs to obtain the yearly gradient which represents the rate of prescribing each year. T-test was used to determine the significance of change in prescribing rate before and after the intervention.

Findings

The rate of prescribing of total antibiotics, Amoxicillin, Co-Amoxiclav and Nitrofurantoin in the intervention group declined in the post-intervention period. However, only Co-Amoxiclav had a significant reduction. In contrast, the control group showed a significant increase in total antibiotics and Co-Amoxiclav prescribing rates.

Implications

The results indicate a small but positive effect in lowering antibiotic prescribing despite its insignificance owing to the nature of data collected as the intervention excluded some conditions for prescribing certain antibiotics. Due to its positive effect, LAMP intends to continue for a total of five years in West Yorkshire as further analysis of this low-cost intervention would be beneficial to determine its effectiveness in reducing AMR.