Promoting sugar-free medicines: evaluation of a multi-faceted intervention

To evaluate an intervention to increase the proportion of medicines prescribed as sugar-free formulations by general practitioners.

Natural experiment.

Interventions were set in Camden and Islington Health Authority with comparator data within that and adjacent health authorities.

General medical practices.

Two interventions were employed. A prescribing incentive scheme that used the proportion of medicines prescribed as sugar-free formulations as a quality marker for general practitioners and a publicity campaign for health care workers and members of the public.

The proportions of amoxycillin mixture and all paracetamol liquid preparations that were prescribed in sugar-free formulations.

Sugar-free prescribing in the practices participating in the incentive scheme increased from 27% to 45% whereas non-participating practices showed a decrease from 20% to 14%. The proportion of prescriptions for sugar-free formulations increased by approximately one half across the entire health authority so that after two years Camden and Islington had the highest level of prescribing of sugar-free paracetamol and amoxycillin in London.

These data provide compelling evidence of the effectiveness of the prescribing incentive scheme whereas the publicity campaign did not change prescribing behaviour.