Using Point-of-care C-reactive protein to guide Antibiotic prescribing for Respiratory tract infections in Elderly nursing home residents

Using Point-of-care C-reactive protein to guide Antibiotic prescribing for Respiratory tract infections in Elderly nursing home residents - UPCARE

Status

Active, not recruiting

Phases

Unknown

Study type

Interventional

Source

NL-OMON

Registry ID

NL-OMON48719

Enrollment

671

Registered

2018-03-28

Start date

2018-09-04

Completion date

Unknown

Last updated

2024-04-15

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Lower respiratory tract infection

Interventions

ln the control group, care as usual is provided for patients with suspected LRTI: the evaluation of suspected LRTI is based on the examination of clinical signs and symptoms, possibly supplemented w

Eligibility

Age

18 Years to 99 Years

Inclusion criteria

Inclusion criteria: Nursing home residents with a new diagnosis *suspected lower respiratory tract infection*

Exclusion criteria

Exclusion criteria: - The patient resides at a palliation/hospice care department of the nursing home - The patient wishes not to be treated with antibiotics (anymore) - The patient is already taking antibiotics - The patient is (also) diagnosed with a different type of infection

Design outcomes

Primary

Measure	Time frame
CENTRAL RESEARCH QUESTION: Determinant: use of CRP POCT (yes/no) Outcome: antibiotic prescribing for patients with suspected LRTI at index consultation (yes/no) SUB RESEARCH QUESTION 1A: Determinant: signs and symptoms Outcome: CRP-value SUB RESEARCH QUESTION 1B: Determinant: CRP-value Outcome: antibiotic prescribing (yes/no) SUB RESEARCH QUESTION 2: Determinant: costs related to intervention (CRP POCT and regular health care costs) versus control (regular health care costs) Outcome: percentage of antibiotic prescribing, reduction in antibiotic prescribing in euros. SUB RESEARCH QUESTION 3: potential barriers and facilitators for the use and implementation of CRP POCT in NHs.	—

Measure

Time frame

CENTRAL RESEARCH QUESTION: Determinant: use of CRP POCT (yes/no) Outcome: antibiotic prescribing for patients with suspected LRTI at index consultation (yes/no) SUB RESEARCH QUESTION 1A: Determinant: signs and symptoms Outcome: CRP-value SUB RESEARCH QUESTION 1B: Determinant: CRP-value Outcome: antibiotic prescribing (yes/no) SUB RESEARCH QUESTION 2: Determinant: costs related to intervention (CRP POCT and regular health care costs) versus control (regular health care costs) Outcome: percentage of antibiotic prescribing, reduction in antibiotic prescribing in euros. SUB RESEARCH QUESTION 3: potential barriers and facilitators for the use and implementation of CRP POCT in NHs.

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Secondary

Measure	Time frame
Secondary variables measured in the cRCT: At index consultation: o Patient characteristics (e.g. demographics) o Symptoms (e.g. cough, fever, confusion) o Additional diagnostics (e.g. culture, X-ray, CRP laboratory test (venipuncture blood)) o Information on antibiotic prescribing (type, dosage, duration) At follow-up consultations: o Patient recovery (yes/no; clinical signs and symptoms: increase/decrease/no change in type or severity of symptoms). o Changes in treatment policy (e.g. additional diagnostics; changes in antibiotic prescribing (yes/no, type, dosage, duration) o Hospital referral o Complications o Mortality During total period of cRCT: o Total number of antibiotic prescriptions per nursing home organization Secondary variables in the cost-effectiveness study: Costs related to the use of the CRP POCT, antibiotic prescriptions, consultation of physicians in the nursing home, additional diagnostics, hospital referral and other health care usage, and complications of treatment.	—

Measure

Time frame

Secondary variables measured in the cRCT: At index consultation: o Patient characteristics (e.g. demographics) o Symptoms (e.g. cough, fever, confusion) o Additional diagnostics (e.g. culture, X-ray, CRP laboratory test (venipuncture blood)) o Information on antibiotic prescribing (type, dosage, duration) At follow-up consultations: o Patient recovery (yes/no; clinical signs and symptoms: increase/decrease/no change in type or severity of symptoms). o Changes in treatment policy (e.g. additional diagnostics; changes in antibiotic prescribing (yes/no, type, dosage, duration) o Hospital referral o Complications o Mortality During total period of cRCT: o Total number of antibiotic prescriptions per nursing home organization Secondary variables in the cost-effectiveness study: Costs related to the use of the CRP POCT, antibiotic prescriptions, consultation of physicians in the nursing home, additional diagnostics, hospital referral and other health care usage, and complications of treatment.

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Countries

Netherlands

Outcome results

None listed

Source: NL-OMON (via WHO ICTRP)