PT - JOURNAL ARTICLE AU - Hannah B Edwards AU - Maria Theresa Redaniel AU - Carlos Sillero-Rejon AU - Ruta Margelyte AU - Tim J Peters AU - Kate Tilling AU - William Hollingworth AU - Hugh McLeod AU - Pippa Craggs AU - Elizabeth Hill AU - Sabi Redwood AU - Jenny Donovan AU - Emma Treloar AU - Ellie Wetz AU - Natasha Swinscoe AU - Gary A Ford AU - John Macleod AU - Karen Luyt TI - National PReCePT Programme: a before-and-after evaluation of the implementation of a national quality improvement programme to increase the uptake of magnesium sulfate in preterm deliveries AID - 10.1136/archdischild-2022-324579 DP - 2023 Jan 02 TA - Archives of Disease in Childhood - Fetal and Neonatal Edition PG - fetalneonatal-2022-324579 4099 - http://fn.bmj.com/content/early/2023/01/01/archdischild-2022-324579.short 4100 - http://fn.bmj.com/content/early/2023/01/01/archdischild-2022-324579.full AB - Objective To evaluate the effectiveness and cost-effectiveness of the National PReCePT Programme (NPP) in increasing use of magnesium sulfate (MgSO4) in preterm births.Design Before-and-after study.Setting Maternity units (N=137) within NHS England and the Academic Health Science Network (AHSN) in 2018.Participants Babies born ≤30 weeks’ gestation admitted to neonatal units in England.Interventions The NPP was a quality improvement (QI) intervention including the PReCePT (Preventing Cerebral Palsy in Pre Term labour) QI toolkit and materials (preterm labour proforma, staff training presentations, parent leaflet, posters for the unit and learning log), regional AHSN-level support, and up to 90 hours funded backfill for a midwife ‘champion’ to lead implementation.Main outcome measures MgSO4 uptake post implementation was compared with pre-NPP implementation uptake. Implementation and lifetime costs were estimated.Results Compared with pre-implementation estimates, the average MgSO4 uptake for babies born ≤30 weeks’ gestation, in 137 maternity units in England, increased by 6.3 percentage points (95% CI 2.6 to 10.0 percentage points) to 83.1% post implementation, accounting for unit size, maternal, baby and maternity unit factors, time trends, and AHSN. Further adjustment for early/late initiation of NPP activities increased the estimate to 9.5 percentage points (95% CI 4.3 to 14.7 percentage points). From a societal and lifetime perspective, the health gains and cost savings associated with the NPP effectiveness generated a net monetary benefit of £866 per preterm baby and the probability of the NPP being cost-effective was greater than 95%.Conclusion This national QI programme was effective and cost-effective. National programmes delivered via coordinated regional clinical networks can accelerate uptake of evidence-based therapies in perinatal care.Anonymised individual-level data for this study are from the NNRD. Our data sharing agreement with the NNRD prohibits sharing data extracts outside of the University of Bristol research team. The NNRD data dictionary is available online and copies of the Statistical analysis plan are available at the University of Bristol’s institutional repository ( https://research-information.bris.ac.uk/en/projects/national-precept-prevention-of-cerebral-palsy-in-pre-term-labour- ).