Developing and Evaluating Interventions to Reduce Inappropriate Prescribing of Antibiotics in Primary Care

NCT ID: NCT01206738

Last Updated: 2017-06-02

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

270 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-11-30

Study Completion Date

2012-09-30

Brief Summary

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1. Do paper-based and web-based intervention modelling experiments (the methodology we are developing) identify the same predictors of GP behaviour regarding prescribing of antibiotics for upper respiratory tract infections?
2. Can a web-based IME system provide trialists with richer and more predictive information upon which to base the development of behavioural change interventions than paper-based IME systems?

Detailed Description

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The NHS needs effective quality improvement interventions to be put into clinical practice, which requires effective behaviour change interventions. Intervention modelling experiments (IMEs) are a way of exploring and refining an intervention before moving to a full-scale trial. They do this by delivering key elements of the intervention in a simulation that approximates clinical practice by, for example, presenting GPs with a clinical scenario about making a treatment decision. Earlier IMEs have been paper-based, which limits what can be done in the simulation.

Web-based IMEs provide the potential for better clinical simulations, which have the potential to lead to better interventions. The current proposal will run a full, web-based IME involving 250 GPs that will advance the methodology of IMEs by directly comparing results with an earlier paper-based IME. Moreover, the web-based IME will evaluate an intervention that can be put into a full-scale trial that aims to reduce antibiotic prescribing in primary care. Reducing inappropriate prescribing of antibiotics in general practice is a national priority; indeed, antibiotic use is increasing in the UK and Scotland's prescribing is second highest amongst UK administrations. More effective behaviour change interventions are needed and this proposal will develop one such intervention and a system to model and test future interventions. This system will be applicable to any situation in the NHS where behaviour needs to be modified, including interventions aimed directly at the public.

Conditions

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Antibiotic Prescribing by GPs for URTI

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Persuasive communication

The persuasive intervention aimed to reinforce the GP's beliefs about the positive consequences of managing sore throat without prescribing antibiotics.

Group Type EXPERIMENTAL

Persuasive communication

Intervention Type BEHAVIORAL

The persuasive intervention aimed to reinforce the GP's beliefs about the positive consequences of managing sore throat without prescribing antibiotics.

Alternative intervention

This intervention was an action plan, supporting the GP to deal with two difficult prescribing situations: 1) a distressed patient (or often distressed parent of a child patient) 2) a patient demanding an antibiotic

Group Type EXPERIMENTAL

Action plan

Intervention Type BEHAVIORAL

This intervention was an action plan, supporting the GP to deal with two difficult prescribing situations: 1) a distressed patient (or often distressed parent of a child patient) 2) a patient demanding an antibiotic

General information

No additional information was provided; the general information was the information already available to GPs about antibiotic prescribing.

Group Type ACTIVE_COMPARATOR

General intervention

Intervention Type BEHAVIORAL

No additional information was provided; the general information was the information already available to GPs about antibiotic prescribing.

Interventions

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Persuasive communication

The persuasive intervention aimed to reinforce the GP's beliefs about the positive consequences of managing sore throat without prescribing antibiotics.

Intervention Type BEHAVIORAL

Action plan

This intervention was an action plan, supporting the GP to deal with two difficult prescribing situations: 1) a distressed patient (or often distressed parent of a child patient) 2) a patient demanding an antibiotic

Intervention Type BEHAVIORAL

General intervention

No additional information was provided; the general information was the information already available to GPs about antibiotic prescribing.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* GPs in Scotland.

Exclusion Criteria

* Unable to obtain both an email address and a postal address for the GP.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Aberdeen

OTHER

Sponsor Role collaborator

Newcastle University

OTHER

Sponsor Role collaborator

University of Southampton

OTHER

Sponsor Role collaborator

Chief Scientist Office of the Scottish Government

OTHER_GOV

Sponsor Role collaborator

Scottish Primary Care Research Network

UNKNOWN

Sponsor Role collaborator

Scottish School of Primary Care

UNKNOWN

Sponsor Role collaborator

University of Dundee

OTHER

Sponsor Role lead

Responsible Party

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Shaun Treweek

Senior Lecturer

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Shaun Treweek, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Dundee

Locations

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University of Dundee

Dundee, Tayside, United Kingdom

Site Status

Countries

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United Kingdom

References

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Treweek S, Ricketts IW, Francis J, Eccles M, Bonetti D, Pitts NB, Maclennan G, Sullivan F, Jones C, Weal M, Barnett K. Developing and evaluating interventions to reduce inappropriate prescribing by general practitioners of antibiotics for upper respiratory tract infections: a randomised controlled trial to compare paper-based and web-based modelling experiments. Implement Sci. 2011 Mar 3;6:16. doi: 10.1186/1748-5908-6-16.

Reference Type BACKGROUND
PMID: 21371323 (View on PubMed)

Treweek S, Barnett K, Maclennan G, Bonetti D, Eccles MP, Francis JJ, Jones C, Pitts NB, Ricketts IW, Weal M, Sullivan F. E-mail invitations to general practitioners were as effective as postal invitations and were more efficient. J Clin Epidemiol. 2012 Jul;65(7):793-7. doi: 10.1016/j.jclinepi.2011.11.010. Epub 2012 Feb 4.

Reference Type RESULT
PMID: 22306007 (View on PubMed)

Treweek S, Bonetti D, Maclennan G, Barnett K, Eccles MP, Jones C, Pitts NB, Ricketts IW, Sullivan F, Weal M, Francis JJ. Paper-based and web-based intervention modeling experiments identified the same predictors of general practitioners' antibiotic-prescribing behavior. J Clin Epidemiol. 2014 Mar;67(3):296-304. doi: 10.1016/j.jclinepi.2013.09.015. Epub 2013 Dec 31.

Reference Type RESULT
PMID: 24388292 (View on PubMed)

Treweek S, Francis JJ, Bonetti D, Barnett K, Eccles MP, Hudson J, Jones C, Pitts NB, Ricketts IW, Sullivan F, Weal M, MacLennan G. A primary care Web-based Intervention Modeling Experiment replicated behavior changes seen in earlier paper-based experiment. J Clin Epidemiol. 2016 Dec;80:116-122. doi: 10.1016/j.jclinepi.2016.07.008. Epub 2016 Jul 26.

Reference Type RESULT
PMID: 27470610 (View on PubMed)

Other Identifiers

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CZH/4/610

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

2010PS10

Identifier Type: -

Identifier Source: org_study_id

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