CompletedNot Applicable

Improving Antibiotic Prescribing for Pediatric Respiratory Infections by Family Physicians With Peer Comparison

39 participantsStarted 2015-08-01

Plain-language summary

Findings from an ongoing improvement project to improve antibiotic prescribing for children and adolescents for three acute respiratory tract infections (ARTIs: upper respiratory tract infection, acute bacterial sinusitis, and acute otitis media) among pediatric and family medicine clinics revealed performance gaps between the two primary care specialties. An improvement project was then set up to address the lower performance by family medicine clinics. Literature review revealed that, in general, quality improvement feedback was more effective if provided to individual clinicians rather than to a group of clinicians, but very limited data existed for antibiotic prescribing practices actually comparing individual clinician feedback to group (clinic-level) feedback. The hypothesis is that individual clinician data feedback is superior to group (clinic-level) feedback in improving antibiotic prescribing for ARTIs in children and adolescents by family medicine clinicians. The aim is to determine if there are significant differences for antibiotic prescribing for ARTIs and for broad spectrum antibiotic prescribing percentage between an intervention group and a comparator group of family medicine clinics after the intervention starting November 2015 and ending December 2018. A cluster randomized trial was designed for 39 family medicine clinics. The intervention group received clinician-level and clinic-level data feedback monthly, and the comparator group received clinic-level only feedback monthly.

Who can participate

Sex

ALL

See this in plain English?

AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria * Family Medicine clinic in Novant Health Medical Group with performance on the upper respiratory infection measure \< 85 per cent for the 6-month period, January- June 2015 * Email agreement to participate for the clinic by the lead clinician for the clinic. Exclusion Criteria * Family Medicine clinic in Novant Health Medical Group with performance on the upper respiratory infection measure ≥ 83 per cent for the 6-month period, January - June 2015, * \< 20 illness encounters for the upper respiratory infection measure recorded by the clinic for the 6-month period, January - June 2015, * Email declination for the clinic by the lead clinician for the clinic

Questions worth asking your doctor

Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.

1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?

Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.

Questions for the trial coordinator

The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.

1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?

A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.

What they're measuring

Proportion of encounters with guideline-appropriate use of antibiotics for upper respiratory tract infection (URI or common cold) in participants 3 months - 18 years of age

Timeframe: 60 months, January 1, 2014 - October 31, 2015 (baseline period), November 1, 2015 - December 31, 2017 (intervention period), and January 1, 2017 - December 31, 2018 (post-intervention period)

Proportion of encounters with guideline-appropriate use of antibiotics for acute bacterial sinusitis in participants 1 - 18 years of age

Timeframe: 60 months,January 1, 2014 - October 31, 2015 (baseline period), November 1 - December 31, 2017 (intervention period), and January 1, 2017 - December 31, 2018 (post-intervention period)

Proportion of encounters with guideline-appropriate use of antibiotics for acute otitis media in participants 6 months - 12 years years of age

Trial details

NCT IDNCT04588376

SponsorHerb Clegg

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2018-12-31

View on ClinicalTrials.gov More Upper Respiratory Infection trials