Demonstration of Near Zero Antibiotic Prescribing for Acute Bronchitis

NCT ID: NCT01240174

Last Updated: 2017-02-01

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 400 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2011-03-31
• Study Completion Date: 2014-07-31

Brief Summary

Studies show, guidelines state, and performance measures assert that antibiotic prescribing for uncomplicated acute bronchitis is inappropriate. However, clinicians prescribe antimicrobials in over 60% of the 22.5 million acute bronchitis visits in the United States each year. Previous successful interventions have only reduced the antimicrobial prescribing rate to 40% or 50%. It is unknown if the antimicrobial prescribing rate for acute bronchitis can be brought to near zero percent in actual practice while maintaining patient safety and satisfaction. The goal of this study is to develop an Electronic Health Record (EHR)-integrated algorithm for the diagnosis and treatment of adults with acute bronchitis with a goal of reducing the antibiotic prescribing rate to near zero percent.

Detailed Description

We will use a multi-modal implementation - including computerized decision support, reporting tools, and clinician feedback - and quality improvement techniques to ensure adherence to the algorithm and reduce the antimicrobial prescribing rate to near zero percent. The duration of the intervention will be 4 years.

Conditions

Bronchitis; Cough

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: NONE

Study Groups

Intervention Arm

Single arm in the study of doctors receiving feedback about their antibiotic prescribing rate for acute bronchitis.

Group Type: OTHER

Demonstration of near zero antibiotic prescribing for patients with acute bronchitis

Intervention Type: BEHAVIORAL

A controlled, continuously-monitored, implementation of an EHR-integrated diagnosis and treatment algorithm for acute bronchitis in a large, diverse primary care practice.

Interventions

Demonstration of near zero antibiotic prescribing for patients with acute bronchitis

A controlled, continuously-monitored, implementation of an EHR-integrated diagnosis and treatment algorithm for acute bronchitis in a large, diverse primary care practice.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• first visit in 30 days, age 18-64, has a cough of less than 3 weeks duration

Exclusion Criteria

• infiltrate on chest x-ray, has chronic lung disease

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 64 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Agency for Healthcare Research and Quality (AHRQ)

FED

Sponsor Role: collaborator

Brigham and Women's Hospital

OTHER

Sponsor Role: lead

Responsible Party

Jeffrey A. Linder

Associate Physician

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Jeffrey A Linder, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Brigham and Women's Hospital, Harvard Medical School

Locations

Brigham and Women's Hospital Jen Center for Primary Care

Boston, Massachusetts, United States

Countries

United States

Other Identifiers

2010P001247

Identifier Type: -

Identifier Source: org_study_id