Box 1.

Implementation of Ivers et al ’s10 components of effective audit and feedback

ComponentImplementation into study
The source of feedback is a supervisor or colleagueFeedback report sent with signatures from three key lead clinicians in the health board (health board’s clinical director, chair of Primary Care Prescribing Management Group, and lead clinician for Prescribing Services)
Feedback is provided more than onceFeedback sent three times over a 13-month period, with a refreshed up-to-date analysis in each report
Feedback includes both explicit targets and an action planFeedback included key messages that supported and encouraged actions expected to be taken by prescribers for the patient with PIP (for example, medication review and/or referral to specialist services) and actions taken in the practice to improve prescribing processes that directly influence PIP (for example, changing the prescription record to increase control of further repeat prescribing)
Baseline performance is lowEnsured PIP present in all practices
Feedback is delivered in both verbal and written formatsFeedback was sent by email to the practice’s secure clinical email address and copied to the practice’s prescribing support team pharmacist (Supplementary Table S1)
  • PIP = potentially inappropriate prescribing.