NICE Bites User Survey Report December 2010 Introduction NICE

nice bites user survey report december 2010 introduction nice bites is a monthly bulletin for healthcare professionals. the pur

NICE Bites User Survey Report
December 2010
Introduction
NICE Bites is a monthly bulletin for healthcare professionals. The
purpose of this publication is to provide a clear and succinct summary
of key prescribing points taken from NICE guidance. It emerged from
collaboration with colleagues in primary care in response to a need
for information which is easily accessible. To assess the impact of
this publication by seeking the views of the readers a survey was
undertaken using Zoomerang web based software. The survey was launched
on 21st September 2010 and was active for six weeks. Readers were
signposted to the survey via the NICE Bites email and bulletin in
September and October, and could also access it via the National
electronic Library for Medicines at www.nelm.nhs.uk.
Survey Results
Over the six week period of the survey, 160 completed responses were
received. The following is a summary of the data responses from each
question:
1. What is your main professional role?
There were 14 health professional categories listed in this question.
Data from these have been collated into ten main professional groups
(see Figure 1). 160 respondents gave 165 responses reflecting the fact
that some people have responsibilities within different specialities.
Two respondents worked in both primary and secondary care, one worked
as a primary care nurse and NHS Direct staff member, one worked as a
public health professional and a manager. Figure 1 shows the
proportion of respondents for each category. 58% of respondents were
pharmacists, and 7% pharmacy technicians. NICE Bites is sent directly
via email primarily to pharmacists and so this result is as expected.
16% (n=27) of respondents were GPs or GP trainees and 7% were nurses.
Figure 1

2. Which sector do you work in most of your time?
Figure 2 shows the proportion of respondents within the NHS working in
primary and secondary care and any non-NHS personnel.

Figure 2

72% of respondents work in primary care. Only 26% of respondents work
in secondary care. These results highlight that there may be a need to
promote this publication more widely within secondary care.
3. Where do you work most of the time?
NICE Bites was produced to support NICE implementation within the
North West SHA. Following its introduction however, requests were
received for this bulletin from further afield. Our survey results
show that 46% of respondents (n=75) work in the North West SHA. The
proportion of respondents from each SHA in England is shown in Figure
3. 10% of respondents work in Wales, 7% in Northern Ireland and 1% in
Scotland. One respondent was from the Isle of Man. Some respondents
were from outside the UK: Spain (n=1), Germany (n=1) and Saudi Arabia
(n=1).

Figure 3
Country
Percentage of respondents
England
79%
Wales
10%
Northern Ireland
7%
Scotland
1%
Isle of Man
<1%
Spain
<1%
Germany
<1%
Saudi Arabia
<1%
4. Are you a prescriber?
62% of respondents were not prescribers, 38% were; Figure 4 shows the
proportion of prescribers by professional group. NICE Bites focuses on
the main prescribing recommendations from NICE guidance. Although not
all respondents are prescribers some may provide prescribing support
(see Question 13). These results highlight that there may be an
opportunity to raise awareness of this publication and increase uptake
by prescribers. However, it is also recognised that there may be a low
response to the online survey from this group.

Figure 4
5. How do you access NICE Bites?
NICE Bites is sent to over 500 people each month directly via an email
distribution list and is also accessible online. Each month it is
published on the National electronic Library for Medicines at
www.nelm.nhs.uk and is also available via the East Lancashire Health
Economy Medicines Management Board website at www.elmmb.nhs.uk .
There were 182 responses to this question. 75% of respondents received
NICE Bites via email and 29 % access it online; see Figure 5.

Figure 5
* Total percentages exceed 100 as multiple responses were allowed for
this question.
6. Have you accessed NICE Bites online at any of the following sites?
Survey respondents were asked which websites they used to access NICE
Bites. Multiple responses were allowed. There were 180 responses.
Figure 6 shows the proportion of respondents that accessed NICE Bites
online and at which site, if any.

Figure 6
* Total percentages exceed 100 as multiple responses were allowed for
this question.
40% of respondents do not access NICE Bites online. Of these 14% are
not aware it is available online. This highlights the need to increase
awareness of online access and signpost readers to available websites.
7
Figure 7
. How often do you access NICE Bites?

52% of respondents access NICE Bites once a month which is likely to
be when the bulletin is published. 8% (n=13) of respondents selected
‘other’; ten of these stated that they accessed NICE Bites upon
receipt.
8. Do you send NICE Bites to anyone?
42% (n=67) of respondents forward NICE Bites on to other people (see
Questions 9 and 10 for further details).
9. How do you distribute NICE Bites?
Multiple responses were allowed for this question.There were 86
responses from 67 respondents; 80% of respondents used email to
distribute NICE Bites, 15% inserted a hyperlink in an electronic
bulletin and 8% upload it onto an intranet. Distribution of paper
copies is used by 21% of respondents. One respondent discusses NICE
Bites with GPs at a monthly meeting.

Figure 8
* Total percentages exceed 100 as multiple responses were allowed for
this question.
10. How many people do you send it to?
Figure 9 shows how many people are included in distribution cascades
within the following bands; 0-10, 11-50, 51-100, other.
Figure 9

Five respondents chose ’other’. These responses are as follows;
*
for distribution further,
*
all GPs in the PCT (>100),
*
all GPs, practice managers and NMPs,
*
500 people,
*
everybody in the organisation has access.
From these figures it is estimated that NICE Bites is distributed to
over 2,000 people from the 67 respondents. Higher figures would be
expected if these results are replicated across the wider readership
of NICE Bites.
Questions 11, 12 and 15 to 17: Which format do you prefer?
Of 160 respondents 49% preferred PDF format and 36% stated no
preference. Only 17% preferred Word format. 25% of respondents copy
and paste sections of NICE Bites into their own
formulary/publications. This percentage is much less than the
percentage of respondents that distribute NICE Bites to others. These
results suggest that most respondents use NICE Bites in its entirety.
Of 160 respondents;
*
97% thought that two sides of A4 was an appropriate length for
NICE Bites.
*
96% thought that there was enough detail in the content of the
bulletin.
*
88% of respondents thought that NICE Bites should be published
monthly as it is currently.
These results suggest that no change is needed to the format and
content of the bulletin.
13. How do you use NICE Bites?
Multiple responses were allowed for this question. There were 482
responses from 160 respondents. See Figure 10.

Figure 10
* Total percentages exceed 100 as multiple responses were allowed for
this question.
NICE Bites is used in a variety of ways. These results show that
respondents primarily used NICE Bites as a reference source. 46% of
respondents use NICE Bites in implementation of NICE guidance. From
the ‘other’ responses NICE Bites is also used in newsletters (n=3),
formularies (n=2), for discussion with GPs (n=3) and in answering
medicines information enquiries (n=1).
14. Do you find NICE Bites easy to read?

Figure 11
18. Which NICE publications should be included in NICE Bites?
Multiple responses were allowed for this question. There were 229
responses from 160 respondents.

Figure 11
* Total percentages exceed 100 as multiple responses were allowed for
this question.
Currently NICE Technology appraisals are not included in NICE Bites
but as 44% of respondents would like these to be included this needs
to be reconsidered.
19. Is the timescale of guidance included in NICE Bites appropriate?
NICE Bites aims to include new guidance within one month of
publication by NICE.
*
99% of respondents thought that this timescale was appropriate.
20. Is it helpful to include NICE guidance published prior to 2009?
*
76% of respondents would find it helpful to include NICE Guidance
published prior to 2009.
21. Is NICE Bites relevant to your practice?

Figure 12
22. Have you ever been prompted to change your practice after reading
NICE Bites?
54% of respondents were prompted to change their practice. 24
respondents gave examples. A sample of these answers is as follows;
*
Increased warfarin prescription for AF. Awareness of CHAD2
*
NICE Clinical Guideline on heart failure (HF) – switch to licensed
beta blocker
*
Use beta blocker in HF in patient with COPD
*
Refer HF patients for rehab
*
Reduce use of ezetimibe with statin
*
Use NICE Bites as a training tool within practice on a regular
basis
*
Review of practice guidelines and audit of prescribing
*
We have changed our prescribing to accommodate NICE guidelines
23. Would you recommend NICE Bites to your colleagues?
100% of respondents would recommend this publication to others.
24. Any further comments?
35% (n= 57) of respondents also provided further positive comments. A
sample of these are included on the final page of this document.
Summary
The results from the NICE Bites User survey have been very encouraging
and show that this publication is recognised as a useful resource. 160
completed responses were received. Pharmacists are the main
professional group that completed the survey (58% of respondents),
followed by GPs (16%) and nurses (7%). 72% of respondents work in
primary care. 38% of respondents are prescribers.
75% of respondents access NICE Bites via email and 29% access it
online. NICE Bites is published on the National electronic Library for
Medicines website at www.nelm.nhs.uk. 41% of respondents access NICE
Bites at this site. 40% of respondents do not access NICE Bites online
and of these 14% are not aware it is available online. In the words of
one respondent, “it needs to be more easily accessible. Difficult to
find on the internet – I only heard by word of mouth. RSS feed isn’t
clear and I have no idea how to get it delivered by email.” This
highlights the need to increase awareness of online access.
Results from the survey confirm that NICE Bites includes information
which is relevant to prescribers, in a format which is easy to read
and of an appropriate length.
It is an adaptable resource which is used in a variety of ways. 25% of
respondents copy and paste sections into their own formularies. 46% of
respondents use NICE Bites in the implementation of NICE guidance.
As a result of this survey the following actions need to be
considered:
*
extend the email distribution list. This will be a considerable
administrative burden and will need allocation of additional
resources.
*
include NICE technology appraisals in future editions of NICE
Bites.
*
give consideration to new ways of access as technology advances
*
signpost readers to online access in the NICE Bites monthly email
and bulletin:
The National electronic Library for Medicines at
www.nelm.nhs.uk
From the Home page select the ‘Health in Focus’ section.
All previous editions of NICE Bites are within this section.
.
The East Lancashire Health Economy Medicines Management Board at
www.elmmb.nhs.uk
From the Home page, on the left hand side select ‘Newsletters and
minutes’ then select ‘NICE Bites’. All previous editions of NICE Bites
are within this section.

“Excellent resource, excellent format.”


valuable refer
NICE Bites

“Really useful.”
“Fantastic resource.”
9
December 2010 Lindsay Banks
North West Medicines information