Antimicrobial stewardship in primary care through the prevention of unnecessary antibiotic prescribing for viral respiratory infections among older adult patients (aged =65 years) in Ontario, Canada Infections and Infestations
Conditions
Interventions
This study will be conducted as a two-arm, parallel-group randomized controlled trial among actively practicing primary care physicians in Ontario, Canada. Eligible physicians will be randomized 1:1 t
Sponsors
Public Health Ontario
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Primary care physician (family medicine or general practitioner) in Ontario, Canada
Exclusion criteria
Exclusion criteria: 1. Inactive physician, defined as working less than 44 days per year 2. Prescribed fewer than 10 antibiotic prescriptions to patients aged 65 years and older in the most recent year or 2 out of the last 3 years 3. Fewer than 100 outpatient visits with patients aged 65 years or older in the most recent year or 2 out of the last 3 years 4. Fewer than 6 outpatient visits for a viral respiratory infection with patients aged 65 years or older in the most recent year or 2 out of the last 3 years 5. Physicians who previously opted out after receiving antibiotic prescribing feedback letters
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Antibiotic prescribing rate (APR) measured using routinely collected administrative health data from ICES at 6 months post-intervention | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Proportion of unnecessary antibiotic prescriptions (UAP) measured using ICES administrative health data at 6 months post-intervention, percentage of antibiotics prescribed for viral respiratory infections without bacterial codes in patients aged 65 years and older 2. Diagnostic code switching measured using ICES administrative health data at 6 months post-intervention, proportion of respiratory infection codes where antibiotics are not indicated relative to all respiratory infection codes 3. Stratified analyses measured using ICES administrative health data at 6 months post-intervention and stratified by physician gender, career stage, patient volume (Q1- Q4), baseline overall prescribing (Q1-Q4), baseline unnecessary prescribing (Q1-Q4), virtual care (Q1-Q4), primary practice setting (emergency room, primary care), rural location, MyPractice report enrollment, and neighborhood income quintile (Q1-Q5) | — |
Countries
Canada
Contacts
Public ContactKalisha Ramlackhan
Outcome results
None listed