The CHIldren with COugh Randomised Controlled Trial

Conditions

Respiratory tract infections Infections and Infestations Other infectious diseases

Peter S Blair, Grace Young, Clare Clement, Padraig Dixon, Penny Seume et al. (17 authors)

Health Technology Assessment2023-12-012 citations

Multi-faceted intervention to improve management of antibiotics for children presenting to primary care with acute cough and respiratory tract infection (CHICO): efficient cluster randomised controlled trial

Peter S Blair, Grace Young, Clare Clement, Padraig Dixon, Penny Seume et al. (17 authors)

BMJ2023-04-2614 citations

10.1136/bmj-2022-072488

Can primary care research be conducted more efficiently using routinely reported practice-level data: a cluster randomised controlled trial conducted in England?

Peter S Blair, Jenny Ingram, Clare Clement, Grace Young, Penny Seume et al. (17 authors)

BMJ Open2022-07-011 citations

10.1136/bmjopen-2022-061574

Protocol for an ‘efficient design’ cluster randomised controlled trial to evaluate a complex intervention to improve antibiotic prescribing for CHIldren presenting to primary care with acute COugh and respiratory tract infection: the CHICO study

Penny Seume, Scott Bevan, Grace Young, Jenny Ingram, Clare Clement et al. (17 authors)

BMJ Open2021-03-016 citations

10.1136/bmjopen-2020-041769

Interventions

310 GP practices will take part in the study for 12 months. GP practices will be randomised 1:1 into intervention or usual care. The randomisation will be minimised within each CCG taking part by tota

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: The CHICO RCT will recruit GP practices from 15 Clinical Commissioning Groups (CCGs) from demographically diverse regions across England. The population studied will be all children aged 0-9 years registered at practices using the EMISWeb system. The recruitment of practices will be via CCGs using established channels of communication. An internal pilot phase lasting 3 months and using 3 CCGs will help establish best practice for recruiting and communicating with practices before widening to the remaining CCGs over a staggered 4-month recruitment period.

Exclusion criteria

Exclusion criteria: Practices will be asked directly whether they are participating in any antimicrobial stewardship activities during the study period and these will be recorded. If these activities involve concurrent intervention studies where there is potential to confound or modify the effects of our intervention, these practices will be excluded. Children aged 10-14 were considered for inclusion but at this age an increasing number are given antibiotics in tablet form and given the much lower consultation rate in older children the research team decided to exclude this group from the study population.

Design outcomes

Primary

Measure	Time frame
1. The annual rate of dispensed amoxicillin and macrolide prescribed for children (aged 0-9 years registered at the start of the designated period) at each practice over a 12-month period 2. The rate of hospital admission for RTI amongst children aged 0-9 years over a 12-month period	—

Secondary

Measure	Time frame
1. ED attendance rates for RTI over a 12-month period 2. The costs to the NHS of using the CHICO intervention in a cost-consequence analysis 3. Proportion of locums used in the practice 4. Practice antibiotic dispensing rates in 12 months prior to recruitment 5. Effects of the CHICO intervention on practices with GP prescribers only and those with nurse prescribers as well 6. Effects of the CHICO intervention on different child age groups (5-year epochs) 7. Use of the CHICO intervention by practice and over time in terms of both usage over a 12-month period and seasonality 8. The acceptability and the use of the intervention, how it was embedded into practice and whether it was used, assessed using qualitative interviews with clinicians. The CCG staff interviews will be exploring how well practices embedded the intervention into their systems and daily life from their perspective	—

Measure

Time frame

1. ED attendance rates for RTI over a 12-month period 2. The costs to the NHS of using the CHICO intervention in a cost-consequence analysis 3. Proportion of locums used in the practice 4. Practice antibiotic dispensing rates in 12 months prior to recruitment 5. Effects of the CHICO intervention on practices with GP prescribers only and those with nurse prescribers as well 6. Effects of the CHICO intervention on different child age groups (5-year epochs) 7. Use of the CHICO intervention by practice and over time in terms of both usage over a 12-month period and seasonality 8. The acceptability and the use of the intervention, how it was embedded into practice and whether it was used, assessed using qualitative interviews with clinicians. The CCG staff interviews will be exploring how well practices embedded the intervention into their systems and daily life from their perspective

—

Countries

England, United Kingdom

Outcome results

None listed