Is no Prescribing Better than Back up/Delayed Prescribing?

OK. Onto the systematic review now. Cochrane Review of Delayed Prescribing– is no prescribing actually a better thing to do? Well, there are six studies in that review that might have been updated more recently. But the message won’t have changed significantly. And as you can see immediate, lots of people end up using their antibiotics. They may not use all of them and keep some of them at home, but most of them will start using them anyway. Delayed prescription– they found around 28% to 30% will use their antibiotic. And certainly the most recent study that we did, the PIP Study, yeah, just over 30%, I would say, early to middle 30s will use them, which is fine.

If we could get all antibiotic use down to 30%, we’d be doing well. And in the Cochrane system, actually 4%– from our recent study, I would say that that’s on the low side. In the PIPs trial, it was in the mid 20s. So from our experience, there’s around a 10% to 15% difference in the number of people who will end up using an antibiotic if you use delayed prescription properly. The problem about the systematic review of delayed prescriptions done by Cochrane is that the number of studies is relatively few and very underpowered for looking at complications.

NICE, for their guidance, did some modelling, and basically they found– they suggested that delayed prescribing was the most efficient thing to do with lots of these respiratory infections. But it was based on some assumptions based on, basically, our sore throat trial.