Reduction of unnecessary antibiotic prescribing for adult patients with suspected respiratory tract infections Respiratory
Conditions
Interventions
Current interventions, as of 16/05/2022:
A cluster-randomised controlled trial will be carried out to estimate the effectiveness and cost-effectiveness of a complex intervention in reducing antibioti
a computer-based decision support system
virtual peer support
a leaflet for patients
and a letter of commitment to optimise antibiotic use to display in their clinic. The control arm will continue to provide usual care. After 9-12 months, a follow-up audit of 1200 RTI patients for 40
both primary outcome data and secondary outcome data will be collected.
Previous interventions as of 04/08/2021:
A cluster-randomised controlled trial will be carried out to estimate the effectivenes
Sponsors
Anhui Medical University
University of Bristol
Eligibility
Sex/Gender
All
Age
18 Years to 100 Years
Inclusion criteria
Inclusion criteria: Current participant inclusion criteria as of 04/08/2021: Practitioners: All the practitioners working in the recruited township health centres will be invited to participate in the study Patients: 1. Patients with RTIs who are present to seek consultation in the recruited township health centres 2. Aged =18 years old 3. Diagnosed with an RTI in the recruitment consultation: blocked/runny nose, coughing with or without sputum, dry/sore throat, breathing problems, fever, ear inflammation (blocked ear, tinnitus, ear discharges, earache). Previous participant inclusion criteria as of 28/04/2021: Village Practitioners: 1. All the practitioners working in the recruited village clinics will be invited to participate in the study Patients: 1. Adult (aged =18 years old) 2. Diagnosed with RTIs in the recruitment consultation: blocked/runny nose, coughing with or without sputum, dry/sore throat, breathing problems, fever, ear inflammation (blocked ear, Tinnitus, ear discharges, earache) Previous participant inclusion criteria: Village Healthcare Professionals: 1. All the village healthcare professionals working in the village clinics with URTI patients Patients: 2. All the patients with URTIs who are present to seek consultation in the recruited practices
Exclusion criteria
Exclusion criteria: Current participant exclusion criteria as of 04/08/2021: Practitioners: 1. Do not have basic computer skills 2. Not involved in clinical diagnosis and medicine prescribing Patients: 1. Have previously sought treatment for this illness from a normal clinic (not a specialist Covid clinic) 2. Unable to provide fully informed consent (e.g. due to dementia, psychosis, or severe depression) 3. Pregnancy Previous participant exclusion criteria as of 28/04/2021: Village Practitioners: 1. Have basic computer skills 2. Not involved in clinical diagnosis and medicine prescribing Patients: 1. Previously sought treatment for this illness from a normal clinic (not a specialist Covid clinic) 2. Unable to provide fully informed consent (eg dementia, psychosis, or severe depression) 3. Pregnant 4. Immunological deficiencies 5. Non-infective conditions (e.g. pulmonary embolus, heart failure, oesophageal reflux, or serious allergy). Previous participant exclusion criteria: Village healthcare professionals: 1. Healthcare professionals who are not computer literate 2. Healthcare professionals who are not involved in the clinical diagnosis and medicine prescribing Patients: 1. Patient has sought repeat consultation for this illness will be excluded. 2. Patients who is unable to provide consent form (eg, dementia, psychosis, or severe depression) 3. Patient who is pregnant 4. Patient with immunological deficiencies 5. Patient with non-infective disorder (eg, pulmonary embolus, heart failure, oesophageal reflux, or allergy) 6. Patient use of antibiotics in the previous month
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The prescribing rate of antibiotic (oral and intravenous) for RTI patients during the consultations at baseline and follow-up audit (9-12 months after intervention) using patient records | — |
Secondary
| Measure | Time frame |
|---|---|
| Current secondary outcome measures as of 16/05/2022: 1. Patient symptom severity will be assessed through follow-up telephone interview at 7, 14, and 21 days after consultation 2. Patient recovery situation will be assessed through follow-up telephone interview at 7 and 14 days after consultation 3. Patient consumption of prescribed antibiotics will be recorded through follow-up telephone interview at 7, 14 days after consultation 4. Patient attitude, knowledge of the patient leaflet and beliefs will be assessed through followup telephone interview at 7 days after consultation 5. Patient costs will be assessed through follow-up telephone interview at 14, 21 days after consultation 6. Patient EQ5D-5L (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) will be assessed during the initial consultation and also telephone interviews at 7, 14, and 21 days after consultation Previous secondary outcome measures as of 04/08/2021: 1. Patient symptom severity and duration will be assessed through follow-up telephone interview at 7, 14, and 21 days after consultation 2. Patient satisfaction will be assessed during the initial consultation 3. Patient recovery situation will be assessed through follow-up telephone interview at 7 and 14 days after consultation 4. Patient consumption of prescribed antibiotics will be recorded through follow-up telephone interview at 7, 14, and 21 days after consultation 5. Patient attitude, knowledge of the patient leaflet and beliefs will be assessed through follow-up telephone interview at 7 days after consultation 6. Patient cost-effectiveness evaluation will be assessed through follow-up telephone interview at 21 days after consultation 7. Patient EQ5D-5L (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) will be assessed during the initial consultation and also telephone interviews at 7, 14, and 21 days after consultation Previous secondary outcome measures as of 28/04/2021: 1. Patient symp | — |
Countries
China
Contacts
Public ContactLinhai;Wenjuan Zhao;Cong
;
Outcome results
None listed