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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

John Whyte1, Scott Winiecki2, Christina Hoffman3, Kaushal Patel4

  1. 1Chief Medical Officer, WebMD, New York, NY, United States.
  2. 2Director, Safe Use Initiative, U.S. Food and Drug Administration, Silver Spring, MD, United States.
  3. 3Group Vice President, Quality and Strategy, Medscape Education, New York, NY, United States.
  4. 4Group Vice President, Marketing Sciences, WebMD, New York, NY, United States.

Received: 06-12-2019; Accepted: 05-04-2020.

Volume 18, Issue 2 · pp. 1773 · PUBLISHED 24 April 2020 · DOI: 10.18549/PharmPract.2020.2.1773

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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.

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    Whyte, J., Winiecki, S., Hoffman, C., & Patel, K. (2020). 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, 18(2), 1773. https://doi.org/10.18549/PharmPract.2020.2.1773