Acute Upper Respiratory Tract Infections
Conditions
Keywords
Respiratory infections, Primary care, Antibiotics, Delayed prescriptions
Brief summary
Delayed prescriptions have been shown to lower antibiotic use for upper respiratory tract infections (which are mostly viral). This trial will test the hypothesis that if the clinician post-dates the delayed prescription by 2 days, rather than dating it on the day the patient is seen, there will be a further drop in the rate of antibiotic use.
Detailed description
6 family doctors and 2 nurse practitioners in a small rural town will issue delayed antibiotic prescriptions to adult patients with new acute respiratory tract infections. The delayed prescriptions will be randomly dated for either the day of the office visit, or 2 days later. The 2 local pharmacies will note whether the prescription is cashed, and when. It is hypothesised that post-dating the prescription will result in a reduced cashing rate. Each arm of the study (Usual v Post-Dated) will contain 75 subjects. This sample will have the power to detect a 25% change in prescription use.
Interventions
OTHERA delayed prescription dated 2 days after clinical office visit
DRUGUsual Dated
Sponsors
Memorial University of Newfoundland
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults aged 18 years or older * Adults with an untreated upper respiratory tract infection * Adults presenting for the first time to a family physician or a nurse practitioner
Exclusion criteria
* Less that 18 years * Having a clear indication for antibiotic therapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants That Filled a Prescription in 20 Days | 20 days | Prescriptions |
Countries
Canada
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Post-Dated Prescription a delayed prescription dated 2 days after clinical office visit
A delayed prescription dated 2 days after clinical office visit | 0 |
| Usual usual date
Usual Dated | 0 |
| Total | 0 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | some filled early | 42 | 42 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Number of Participants That Filled a Prescription in 20 Days
Prescriptions
Time frame: 20 days
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Post-Dated Prescription | Number of Participants That Filled a Prescription in 20 Days | 16 Participants |
| Usual | Number of Participants That Filled a Prescription in 20 Days | 16 Participants |
p-value: 0.924Chi-squared