Table 2.

Characteristics of studies evaluating nudge interventions to improve antibiotic prescribing in primary care

Author	Country	Sample size	Infections targeted	Nudge intervention/s	Outcomes of interest	Overall risk of bias*
Awad et al34	Sudan	20 practices	All	Social norm feedback	No. of consultations with AB; No. of consultations with an inappropriate AB†	High
BETA35 50	Australia	6608 physicians	All	Social norm feedback	No. of ABs per 1000 consultations	Moderate
Bradley et al36	Northern Ireland	331 practices	All	Social norm feedback	No. of ABs per 1000 registered population	Moderate
Chang56	China	163 physicians	All	Social norm feedback	No. of AB prescriptions per 100 prescriptions	Moderate
Curtis et al51	England	1401 practices	All	Social norm feedback	% broad spectrum AB of all AB	Low
Gerber et al37	USA	162 physicians	RTI	Social norm feedback	% broad spectrum ABs among children with AB prescription; ABs for viral RTI	High
Hallsworth et al38	England	1581 practices	All	Social norm feedback	No. of ABs per 1000 registered population	Low
Hemkens et al39	Switzerland	2900 physicians	All	Social norm feedback	Antibiotic DDD per 1000 consultations	Low
Hürlimann et al40	Switzerland	136 practices	RTI; UTI	Social norm feedback	% AB prescriptions for upper RTIs; % penicillins for RTI; % trimethoprim/sulfamethoxazole for UTI	Moderate
Kronman et al52	USA	57 physicians	RTI	Social norm feedback	% of RTI with AB prescribed	Low
Lagerløv et al41	Norway	199 physicians	UTI	Social norm feedback	% inappropriate ABs for UTI	High
Mainous et al42	USA	216 physicians	RTI	Social norm feedback	% inappropriate AB treatments	Low
Meeker et al43	USA	14 physicians	RTI	Public commitment	No. of ABs per 100 AB inappropriate RTIs	Moderate
Meeker et al44	USA	244 physicians	RTI	Social norm feedback, accountable justification, suggested alternatives	No. of ABs per 100 AB inappropriate RTIs	Moderate
O'Connell et al45	Australia	2440 physicians	All	Social norm feedback	No. of ABs per 100 consultations	Moderate
Persell et al46	USA	28 physicians	RTI	Social norm feedback, accountable justification, suggested alternatives	No. of ABs per 100 RTIs; No. of ABs per 100 AB inappropriate RTIs	High
Ratajczak et al47	England	6995 practices	All	Social norm feedback	No. of ABs per 1000 registered population	Moderate
Søndergaard et al48	Denmark	299 physicians	RTI	Social norm feedback	No. of ABs per 1000 registered population	Moderate
Yang et al49	China	20 practices (54 physicians)	RTI	Public reporting	% of RTI consultations with AB; % of RTI consultations with >1 AB	Low

*Risk of bias assessed using the Cochrane Effective Practice and Organisation of Care group’s tool for studies with a control group. Overall rating assigned ‘low’ when all criteria were ‘low’ risk; ‘medium’ when 1–2 criteria were scored ‘unclear’ or ‘high’ risk; and ‘high’ when >2 criteria were scored ‘unclear’ or ‘high’ risk.

†Inappropriate with respect to antibiotic, doses and/or duration.

AB, antibiotic; DDD, defined daily doses; RTI, respiratory tract infection; UTI, urinary tract infection.