Skip to content

Evaluating decision aids for acute respiratory infections on the use of antibiotics in general practice

Effect of decision aids for acute respiratory infections on the use of antibiotics in general practice: a cluster randomised controlled trial

Status
Completed
Phases
Unknown
Study type
Interventional
Source
ANZCTR
Registry ID
ACTRN12616000644460
Enrollment
122
Registered
2016-05-18
Start date
2016-07-20
Completion date
2018-05-29
Last updated
2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

Antibiotic resistance is an international rapidly growing threat to health care. It is a direct result of antibiotic use and results in not just health resource waste, but significant and avoidable health burdens. Reducing antibiotic use is central to minimising resistance. Primary care is a priority target for reducing use as this is where antibiotics are used most (80% of all human consumption is in the community) AND with least effect, especially for acute respiratory infections (ARI). ARIs are the most common reason for an antibiotic prescription in primary care (>5 million per year in Australia) despite providing minimal benefits and some harms. We have identified that patients overestimate the benefits of antibiotics and underestimate their harms and patient expectations are a key driver of antibiotic prescriptions. Appropriately managing patient expectations in ARI consultations is crucial to reducing inappropriate prescribing. Shared decision making (SDM) provides a means of doing this, enabling the general practitioner (GP) and patient to discuss the benefits and harms of using and not using antibiotics and jointly decide on the most appropriate option. We have established that patients want more involvement in decision-making about ARI management and that SDM reduces antibiotic prescribing in primary care. However methods of implementing SDM are limited and it rarely occurs. We have systematically developed the first set of brief decision aids about antibiotic use for common ARIs and successfully piloted them. This project is a cluster randomised trial to determine whether these evidence-based decision aids (for acute otitis media, sore throat, bronchitis) and a brief training package reduces GPs’ antibiotic prescribing rate.

Interventions

Brief name: Decision aids for ARIs Purpose: The decision aids aim to facilitate shared decision making so that doctors and patients have a conversation about the options of using and not using antibiotics for ARIs, and that the benefits and harms of both options are considered before a decision is collaboratively reached. Procedures: GPs will be given copies of three patient decision aids (one each for acute otitis media, sore throat, and acute bronchitis) and a brief training package (to be co

Brief name: Decision aids for ARIs Purpose: The decision aids aim to facilitate shared decision making so that doctors and patients have a conversation about the options of using and not using antibiotics for ARIs, and that the benefits and harms of both options are considered before a decision is collaboratively reached. Procedures: GPs will be given copies of three patient decision aids (one each for acute otitis media, sore throat, and acute bronchitis) and a brief training package (to be completed at their convenience). Materials: Each decision aid is a two-page (double-sided) document; the training package is a short video (~15 mins) explaining about shared decision making and use of decision aids; a list of frequently asked questions (by GPs) about the decision aids will also be provided. Who provides the intervention; The intervention package will be delivered in person by a trial researcher to GPs shortly after randomisation. No training will be provided during that visit. When and how much: Four weeks after receiving the intervention package, a study researcher will make a brief visit (~5-10 minutes) to each practice to check if any questions. At 6 months, a study newsletter/update will be provided during another brief visit (~5-10 minutes) to answer any queries, or provide further printed copies of the decision aids if needed. After receiving the intervention, it is intended that the decision aids are used, on an ongoing basis, with applicable patients. There will be no further contact with participants following this 6 month contact, unless participants make contact with the researchers. Tailoring: The intervention is not planned to be tailored in any way, although participants may contact and ask the research team questions about the decision aids at any time. Fidelity: Use of the decision aids will be explored in an interview at the end of the study period.

Sponsors

Tammy Hoffmann
Lead SponsorIndividual

Study design

Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes

Inclusion criteria

General practice in the recruitement region

Exclusion criteria

General practice is currently, or within the last 2 years, participated in a research study aimed at reducing antibiotic prescribing

Outcome results

None listed

Source: ANZCTR · Data processed: Feb 4, 2026