We focus on the number of dispensed antibiotics, qualifying for respiratory tract infections, that are prescribed by GPs. Important to note is that the unit of analysis are the GPs and not the patients.
Conditions
Interventions
The intervention for the GPs will consist of three different components:
- An E-learning focused on intercultural skills with 4 lessons of 10-15 minutes each
- An evening training session (3.5 hours) in which GPs will be taught intercultural skills, discuss video-taped consultations with intercultural doctor-patient interactions, and practice the newly lea
- Use of patient materials (written information and an animation movie that will be presented on the website Thuisarts.nl) for immigrant patients in their own language, to be used during consultation.
Sponsors
Erasmus MC, University Medical Center Rotterdam, and the Municipal Health Service of Rotterdam-Rijnmond.
Eligibility
Inclusion criteria
Inclusion criteria: Dutch GPs/locums, with a specific focus on GPs who are located in or around Rotterdam, Amsterdam, The Hague and Utrecht.
Exclusion criteria
Exclusion criteria: - Locums who work at diverse practices. - Locums who work at one practice but who do not prescribe under their individual prescriber code. - GPs from whom the individual prescriber code cannot be identified in the data.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Our primary outcome is the number of dispensed courses of antibiotics qualifying for respiratory tract infections, per 1000 registered patients. For eligible antibiotics, we selected all first and second choice antibiotics that qualify for respiratory tract infections according to the Dutch antibiotic guidelines and expert opinion. This produced the following selection of eight antibiotics: Doxycycline (J01AA02), Amoxicillin (J01CA04), Augmentin (J01CR02), Phenoxymethylpenicillin (J01CE02), Sulphonamides with trimethoprim inclusive derivatives (J01EE), Macrolides (J01FA), Moxifloxacin (J01MA14), and Pheneticillin (J01CE05). To evaluate the effect of the intervention, we will perform a one-way ANCOVA (analysis of covariance) in which we statistically control for the number of dispensed antibiotics at baseline and the differences between the intervention and the control group. The number of dispensed antibiotics at baseline for both groups will be compared with the number of antibiotics during the 6 months following the intervention. We will perform our analysis according to both an intention-to-treat (ITT) and a per-protocol (PP) analysis in which the GPs in the intervention arm who did not follow the training session, will be removed from the analysis. | — |
Secondary
| Measure | Time frame |
|---|---|
| The total number of dispensed courses of antibiotics for all infections (regardless of the origin), per 1000 registered patients. | — |
Contacts
Public ContactDominique Lescure
Erasmus MC
Outcome results
None listed