None listed
Conditions
Brief summary
Financial incentives and external audit plus feedback are designed to motivate General Practitioners (GP) to change their clinical behaviour with the intention of improving the quality of care. Financial incentives are widely used at a significant cost to the Australian Government. Audit plus feedback is a key component of the RACGP Quality Improvement and Continuing Professional Development Program. To date, there is little empirical evidence about the impact of removing financial incentives and/or audit plus feedback on professional performance once they are in place. ACCEPt-able is a randomised trial that aims to investigate whether the removal of financial incentives and or audit plus feedback impacts on GP’s chlamydia testing performance. It will follow on from the Australian Chlamydia Control Effectiveness Pilot (ACCEPt), a trial of the impact of a multifaceted intervention including incentive payments and quarterly audit plus feedback on GPs’ chlamydia testing rates. This trial will be conducted over 36 months involving 60 general practices (approx. 600 GPs) in QLD, NSW, VIC and SA. We have the unique opportunity to re-randomise GPs who participated in ACCEPt, to investigate whether chlamydia testing rates are sustained when incentive payments and/or feedback are removed.
Interventions
Factorial cluster RCT design - 3 intervention groups groups and one control (see below)
1) Incentive payments: This group will continue to receive incentive for each chlamydia test done for 16 to 29 year old men or women. These payments will range from $5 per eligible test for up to 20% coverage to $8 per test for over 40% coverage. The intervention period is up to 2 years.
2) Audit+feedback only: Provision of quarterly chlamydia testing reports to each GP. The report lists the number of patien
Factorial cluster RCT design - 3 intervention groups groups and one control (see below) 1) Incentive payments: This group will continue to receive incentive for each chlamydia test done for 16 to 29 year old men or women. These payments will range from $5 per eligible test for up to 20% coverage to $8 per test for over 40% coverage. The intervention period is up to 2 years. 2) Audit+feedback only: Provision of quarterly chlamydia testing reports to each GP. The report lists the number of patients aged 16 to 29 years the GP has tested during the quarter, his/her chlamydia testing rate for the quarter and for the previous 12 months. The reports will be given both verbally and in writing to the clinic in a quarterly face to face meeting where a study Research Officer will explain the results and discuss how the clinic can further improve their rates. The intervention period is up to 2 years. 3) None: GPs and clinics will NOT receive any incentive payments or audit+feedback on their chlamydia testing performance. The intervention period is up to 2 years.
Sponsors
University of Melbourne
Study design
Allocation
Randomised controlled trial
Intervention model
Factorial
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
20 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
General Practitioners and Practice nurses who work in a general practice that has been participating in the intervention group of ACCEPt are eligible to participate. ACCEPt is a cluster RCT of a chlamydia testing intervention. We propose to re-randomised intervention clinics at the conclusion of the trial to evaluate the importance of incentive payments and audit+feedback. The ACCEPt protocol has been accepted as a Lancet published protocol: Hocking JS, Low N, Guy R, Law M, Donovan B, Kaldor J, Temple-Smith M, Gunn J, Fairley CK. 12 PRT 09010: Australian Chlamydia Control Effectiveness Pilot (ACCEPt): a cluster randomised controlled trial of chlamydia testing in general practice (ACTRN1260000297022) Lancet protocol. Published May 2013. ACCEPt has been registered on the ANZCTR - 1260000297022.
Exclusion criteria
No exclusion criteria
Outcome results
None listed