Converting habits of antibiotic use for respiratory tract infections in German primary care - study protocol of the cluster-randomized controlled CHANGE-3 trial.
Anti-Bacterial Agents
/ adverse effects
Attitude of Health Personnel
Communication
Drug Prescriptions
Education, Medical, Continuing
/ methods
Feedback, Psychological
Germany
Habits
Health Knowledge, Attitudes, Practice
Humans
Inservice Training
/ methods
Multicenter Studies as Topic
Physician-Patient Relations
Physicians, Primary Care
/ education
Practice Patterns, Physicians'
/ trends
Primary Health Care
/ trends
Randomized Controlled Trials as Topic
Respiratory Tract Infections
/ diagnosis
Treatment Outcome
Unnecessary Procedures
Antibacterial agents
Drug prescriptions
Drug resistance
Primary health care
Randomized controlled trial
Respiratory tract infections
Journal
Trials
ISSN: 1745-6215
Titre abrégé: Trials
Pays: England
ID NLM: 101263253
Informations de publication
Date de publication:
06 Feb 2019
06 Feb 2019
Historique:
received:
13
11
2018
accepted:
17
01
2019
entrez:
8
2
2019
pubmed:
8
2
2019
medline:
14
6
2019
Statut:
epublish
Résumé
The overuse of antibiotics is a major cause for the worldwide rise of antibiotic resistance. Although it is well known that acute respiratory tract infections (ARTI) are mainly caused by viruses and are often self limiting, antibiotics are too frequently prescribed in primary care. CHANGE-3 examines whether a complex intervention focusing on improving communication and provision of prescribing feedback reduces antibiotic use in patients suffering from ARTI. The CHANGE-3 trial is a cluster-randomized controlled trial nested within a web-based public campaign conducted in two regions in Germany. A total of 114 medical practices will be included. Practices randomized to the intervention will receive a practice-specific antibiotic-prescription feedback and an educational outreach visit. During the visit the whole practice team will receive an introduction to e-learning modules addressing patient-centered communication on antibiotics. Furthermore, the practices will receive tablet PCs with information on antibiotics and the treatment of ARTI to be presented to patients. Practices randomized to the control will provide care as usual. The primary outcome measure is the antibiotic prescribing rate for patients with a history of ARTI. Data collected before the intervention, during the intervention and after the intervention will be compared. The use of narrow- vs. broad-spectrum antibiotics will be analyzed as a secondary outcome. A process evaluation is also part of the trial. This study should contribute to the growing body of research on reducing antibiotic prescription. ISRCTN, ISRCTN15061174 . Registered retrospectively on 13 July 2018.
Sections du résumé
BACKGROUND
BACKGROUND
The overuse of antibiotics is a major cause for the worldwide rise of antibiotic resistance. Although it is well known that acute respiratory tract infections (ARTI) are mainly caused by viruses and are often self limiting, antibiotics are too frequently prescribed in primary care. CHANGE-3 examines whether a complex intervention focusing on improving communication and provision of prescribing feedback reduces antibiotic use in patients suffering from ARTI.
METHODS/DESIGN
METHODS
The CHANGE-3 trial is a cluster-randomized controlled trial nested within a web-based public campaign conducted in two regions in Germany. A total of 114 medical practices will be included. Practices randomized to the intervention will receive a practice-specific antibiotic-prescription feedback and an educational outreach visit. During the visit the whole practice team will receive an introduction to e-learning modules addressing patient-centered communication on antibiotics. Furthermore, the practices will receive tablet PCs with information on antibiotics and the treatment of ARTI to be presented to patients. Practices randomized to the control will provide care as usual. The primary outcome measure is the antibiotic prescribing rate for patients with a history of ARTI. Data collected before the intervention, during the intervention and after the intervention will be compared. The use of narrow- vs. broad-spectrum antibiotics will be analyzed as a secondary outcome. A process evaluation is also part of the trial.
DISCUSSION
CONCLUSIONS
This study should contribute to the growing body of research on reducing antibiotic prescription.
TRIAL REGISTRATION
BACKGROUND
ISRCTN, ISRCTN15061174 . Registered retrospectively on 13 July 2018.
Identifiants
pubmed: 30728043
doi: 10.1186/s13063-019-3209-7
pii: 10.1186/s13063-019-3209-7
pmc: PMC6366085
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Clinical Trial Protocol
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
103Subventions
Organisme : Bundesministerium für Gesundheit
ID : ZMVI1-2516FSB100
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