Discussion
cystitis
CYSTITIS
Our study described the impact of a personalized prescribing portrait intervention on antibiotic use for UAC in the primary care setting of BC. The prescribing impact from the UAC portrait was greater than previous portraits implemented by the EQIP initiative [FPs were asked to complete a reflective survey where they were asked questions pertaining to the quality of evidence, accuracy of data, and potential for changing their personal treatment decisions for patients with UAC. The responses were overwhelmingly positive, with the majority of physicians indicating they learned something new and described their individual prescribing data as accurate. Less than 2% of the physicians reported being dissatisfied with the content of the portrait. The large sample of physician responses was novel, and offered important feedback and support for the future development of personal prescribing portraits. However, the physicians responding to the survey were not a random sample, and therefore careful interpretation of the results is warranted.Several government programs in BC have aimed at reducing antimicrobial use, including educational campaigns [A systematic review and meta-analysis of audit and feedback interventions calculated an overall adjusted risk difference of 10% improvement in the intervention groups after adjusting for baseline difference [Our intervention had several strengths that may have contributed to the high magnitude of impact. First, comprehensive medication dispensing data was used to twice mail up-to-date personalized prescribing charts, with actionable evidence-based prescribing targets, and peer comparison, to over 2,000 active family physicians. The components of the intervention have been shown to be highly effective [Our study had data limitations that warrant discussion. The use of administrative health claims data is subject to data quality issues. This evaluation relies on the accuracy of diagnosis coding in the MSP database, particularly the use of the ICD-9 code 595 for cystitis. Patient visits for cystitis that were incorrectly coded would not have been included in the evaluation. Another limitation of our study was the randomization of physicians by community. This created baseline geographic imbalances between the intervention and control groups that could be related to antibiotic preference for the treatment of UAC. However, this is very unlikely to explain the magnitude of impact.