An Educational Intervention to Improve the Use of Antibiotics in Portuguese Health Professional

NCT ID: NCT02173509

Last Updated: 2023-08-18

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 2300 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2013-05-31
• Study Completion Date: 2017-12-31

Brief Summary

This is a cluster randomised controlled trial covering all general practitioners working in the National Health System (SNS) and all pharmacists working in community pharmacies in the area covered by the Health Region Administration of Center (ARS-C) . A specific educative intervention, designed from gaps detected in knowledge and attitudes with respect to antibiotics and resistance, will be carried out on the intervention group. The control group will not receive any specific intervention.

Hypotheses:

1. The attitudes and knowledge towards antibiotics generate habits of prescription by physicians

2. The attitudes and knowledge towards to antibiotics generate propensity to dispense antibiotics without prescription by pharmacists

3. The identification of the attitudes, knowledge and factors that generate habits of inadequate prescription will allow the design of specific educative interventions to improve the use of antibiotics

4. The identification of the attitudes, knowledge and factors that generate propensity to dispense antibiotics without prescription will allow the design of specific educative interventions to antibiotic use

5. The interventions designed from gaps detected in knowledge and attitudes with respect to antibiotics and resistance will improve the prescription and dispensation of antibiotics by physicians and pharmacists, respectively.

6. The intervention will collaborate in the control of the bacterial resistance.

Detailed Description

The intervention will consist of group outreach visits (40 minutes), and will be targeted at changing the knowledge-attitudes previously found to be associated with poor prescribing of antibiotics in the case of physicians and propensity to dispense antibiotics without medical prescription in the case of pharmacists.. An observational cohort study of a sample of 1100 primary care physicians and 1200 community pharmacists will be carried out to identify knowledge-attitudes associated with inappropriate prescribing of antibiotics. The independent variables (knowledge-attitudes) will be assessed by a self-administered postal questionnaire and dependent variables are some quantity and quality indicators of the prescribing antibiotics, and consumption data.

Conditions

Antibiotics Misuse

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: NONE

Study Groups

Educational multifaceted intervention

Multidisciplinary and multifaceted educational intervention about antibiotic prescription and dispense, in physicians and pharmacists.

Group Type: EXPERIMENTAL

Multidisciplinary and multifaceted educational intervention.

Intervention Type: OTHER

Outreach visits (40 minutes) which included a PowerPoint presentation and impress materials: poster; flyers; participation certificate and articles mentioned in the presentation. This outreach visit aimed to change the knowledge-attitudes previously identified in a previous study as being associated with poor prescribing of antibiotics in the case of physicians and propensity to dispense antibiotics without medical prescription in the case of pharmacists.

Control

Physicians and pharmacists that not received the multidisciplinary and multifaceted educational intervention about antibiotic prescription and dispense.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Multidisciplinary and multifaceted educational intervention.

Outreach visits (40 minutes) which included a PowerPoint presentation and impress materials: poster; flyers; participation certificate and articles mentioned in the presentation. This outreach visit aimed to change the knowledge-attitudes previously identified in a previous study as being associated with poor prescribing of antibiotics in the case of physicians and propensity to dispense antibiotics without medical prescription in the case of pharmacists.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• All general practitioners working during the period of the study in the National System of Health (SNS)
• All pharmacists working during the period study in the community pharmacies.

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Fundação para a Ciência e a Tecnologia

OTHER

Sponsor Role: collaborator

Aveiro University

OTHER

Sponsor Role: lead

Responsible Party

Maria Teresa Herdeiro

Prof

Responsibility Role: PRINCIPAL_INVESTIGATOR

References

Teixeira Rodrigues A, Roque F, Pineiro-Lamas M, Falcao A, Figueiras A, Herdeiro MT. Effectiveness of an intervention to improve antibiotic-prescribing behaviour in primary care: a controlled, interrupted time-series study. J Antimicrob Chemother. 2019 Sep 1;74(9):2788-2796. doi: 10.1093/jac/dkz244.

Reference Type: DERIVED

PMID: 31257435 (View on PubMed)

Roque F, Teixeira-Rodrigues A, Breitenfeld L, Pineiro-Lamas M, Figueiras A, Herdeiro MT. Decreasing antibiotic use through a joint intervention targeting physicians and pharmacists. Future Microbiol. 2016 Jul;11:877-86. doi: 10.2217/fmb-2016-0010. Epub 2016 Jul 14.

Reference Type: DERIVED

PMID: 27415585 (View on PubMed)

Other Identifiers

PTDC/SAU-ESA/105530/2008

Identifier Type: -

Identifier Source: org_study_id