Evaluation of the impact of Scottish Reduction in Antimicrobial Prescribing (ScRAP) programme on GP Practice management of patients with suspected UTI

Background: Optimising use of antibiotics is a key action to tackle antimicrobial resistance. Aim: To evaluate the impact of an educational intervention on GP Practice teams’ self-reported change in practice in relation to managing patients with UTI. Design and setting: Qualitative analysis of online evaluation and submitted improvement activity summaries from GP Practices in one large region in Scotland Methods: Prescribing support pharmacists delivered facilitated sessions in protected learning time between May 2017 and November 2018, to which all GP practice staff, both clinical and support staff were invited. Practice audits and process mapping were used to consider local practice in context. Participants and facilitators were encouraged to complete an online feedback survey about the learning session. Each GP practice was also asked to complete a summary of improvement activity, outlining changes implemented and their impact. Improvement activity summaries were analysed using NVivo 12pro software to identify key themes. Results: 404 participants and 239 facilitators completed surveys and were positive about the content, approach and length of the session with only minor content changes suggested. Improvement activity forms were submitted by 205 GP practices. Changes in practice included patient education to promote self-management and a reduction in the number of urine specimens sent to microbiology laboratories. Conclusions: Feedback from facilitators and participants informed an update of the programme content. A whole team approach to management of patients with suspected UTI increased the success and impact of the changes made.