FDA collaboration to improve safe use of fluoroquinolone antibiotics: an ex post facto matched control study of targeted short-form messaging and online education served to high prescribers

Pharmacy Practice

  • John Whyte1Chief Medical Officer, WebMD, New York, NY, United States.
  • Scott Winiecki2Director, Safe Use Initiative, U.S. Food and Drug Administration, Silver Spring, MD, United States.
  • Christina Hoffman3Group Vice President, Quality and Strategy, Medscape Education, New York, NY, United States.
  • Kaushal Patel4Group Vice President, Marketing Sciences, WebMD, New York, NY, United States.

Volume 18 Issue 2 Pages 1-10

DOI: 10.18549/PharmPract.2020.2.1773

Abstract

Objective: This ex post facto matched control study was conducted to evaluate the effect of targeted short-form messages or continuing medical education (CME) on fluoroquinolone prescribing among high prescribers. Methods: A total of 11,774 Medscape healthcare provider (HCP) members prescribing high volumes of fluoroquinolones were randomized into three segments to receive one of three unique targeted short-form messages, each delivered via email, web alerts, and mobile alerts. Some HCPs receiving targeted short-form messages also participated in CME on fluoroquinolone prescribing. A fourth segment of HCPs participated in CME only. Test HCPs were matched to third-party-provider prescriber data to identify control HCPs. We used prescriber data to determine new prescription volume; percentage (%) of HCPs with reduced prescribing; new prescription volume for acute bacterial sinusitis (ABS), uncomplicated urinary tract infection (uUTI), and acute bacterial exacerbations of chronic bronchitis in those with chronic obstructive pulmonary disease (ABECB-COPD). Open rates for emailed targeted short-form messages were also measured. Results: Targeted short-form messages and CME each resulted in significant new prescription volume reduction versus control. Combining targeted short-form messages with CME yielded the greatest percentage of test HCPs with reduced prescribing (80.1%) versus controls (76.2%; p<0.0001). New prescription volume decreased significantly for uUTI and ABS following exposure to targeted short-form messages, CME, or both. Targeted short-form messages containing comparative prescribing information with or without clinical context were opened at slightly higher rates (10.8% and 10.6%, respectively) than targeted short-form messages containing clinical context alone (9.1%). Conclusions: Targeted short-form messages and CME, alone and in combination, are associated with reduced oral fluoroquinolone prescribing among high prescribers.

Keywords

  • Antimicrobial Stewardship
  • Drug Resistance
  • Bacterial
  • Fluoroquinolones
  • Prescription Drug Misuse
  • Inappropriate Prescribing
  • Education
  • Medical
  • Continuing
  • Peer Influence
  • Randomized Controlled Trials as Topic
  • United States
Pharmacy Practice

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