Children With Fever and Respiratory Symptoms at Out-of-hours Services in Norway

NCT ID: NCT02496559

Last Updated: 2015-12-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

401 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-01-31

Study Completion Date

2015-07-31

Brief Summary

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Viral self-limiting infections in respiratory organs among children are common in primary care. Serious infections have low prevalence and are challenging to distinguish from self-limiting infections.

Prescription of antibiotics in primary care is still high but stable since 2009 in Norway, and 90% of all antibiotics are prescribed in primary care.

C-reactive protein (CRP) has been especially popular in Norway for point-of-care testing in primary care, but its role in ruling-out serious infections and the cut-off value for prescribing antibiotics has been discussed a lot.

The aim of this study is to identify if pretesting with CRP of all children 0-6 year with fever or respiratory symptoms at Out-of-Hours Services will affect the prescription of antibiotics and the referral to hospital for children.

Detailed Description

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Design: A randomized controlled observational study including children 0-6 year with fever and/or respiratory symptoms at 4 different Out-of-hour Services and at 1 Emergency Children Department Clinic at a hospital (open clinic). The data consist of clinical data and anamnestic information from a nurse at OOH-service collected before the consultation, the doctor's journal and a questionnaire to parents before the consultation and 1 week after the consultation.

Conditions

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Children

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Pre-consultation CRP

Every third child included get a CRP-test before the consultation and the doctor have the answer at start of consultation

Group Type ACTIVE_COMPARATOR

Pre-consultation CRP

Intervention Type PROCEDURE

Use of CRP test on all children with fever before the consultation (intervention) compared to where the doctor requests a CRP test (no intervention)

CRP requested

No intervention, the consultation with children as normal, the CRP is used at doctors request.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Pre-consultation CRP

Use of CRP test on all children with fever before the consultation (intervention) compared to where the doctor requests a CRP test (no intervention)

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Children 0-6 years with fever and/or respiratory symptoms

Exclusion Criteria

* Children older than 6 years with other conditions
Maximum Eligible Age

6 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Haukeland University Hospital

OTHER

Sponsor Role collaborator

NORCE Norwegian Research Centre AS

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Steinar Hunskår, Prof. dr.med

Role: STUDY_DIRECTOR

NORCE Norwegian Research Centre AS

References

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Brent AJ, Lakhanpaul M, Thompson M, Collier J, Ray S, Ninis N, Levin M, MacFaul R. Risk score to stratify children with suspected serious bacterial infection: observational cohort study. Arch Dis Child. 2011 Apr;96(4):361-7. doi: 10.1136/adc.2010.183111. Epub 2011 Jan 24.

Reference Type BACKGROUND
PMID: 21266341 (View on PubMed)

Van den Bruel A, Thompson MJ, Haj-Hassan T, Stevens R, Moll H, Lakhanpaul M, Mant D. Diagnostic value of laboratory tests in identifying serious infections in febrile children: systematic review. BMJ. 2011 Jun 8;342:d3082. doi: 10.1136/bmj.d3082.

Reference Type BACKGROUND
PMID: 21653621 (View on PubMed)

Nordlie AL, Andersen BM. [Changes in antibiotic consumption among day-care children in Oslo]. Tidsskr Nor Laegeforen. 2007 Nov 15;127(22):2924-6. Norwegian.

Reference Type BACKGROUND
PMID: 18026237 (View on PubMed)

Rebnord IK, Sandvik H, Hunskaar S. Use of laboratory tests in out-of-hours services in Norway. Scand J Prim Health Care. 2012 Jun;30(2):76-80. doi: 10.3109/02813432.2012.684208.

Reference Type RESULT
PMID: 22643151 (View on PubMed)

Magnus MC, Vestrheim DF, Nystad W, Haberg SE, Stigum H, London SJ, Bergsaker MA, Caugant DA, Aaberge IS, Nafstad P. Decline in early childhood respiratory tract infections in the Norwegian mother and child cohort study after introduction of pneumococcal conjugate vaccination. Pediatr Infect Dis J. 2012 Sep;31(9):951-5. doi: 10.1097/INF.0b013e31825d2f76.

Reference Type RESULT
PMID: 22627867 (View on PubMed)

Alvsaker LKT, Stensen MF, Mjelle AB, Hunskaar S, Rebnord IK. Outcomes of antibiotic treatment for respiratory infections in children an observational study in primary care. Scand J Prim Health Care. 2024 Jun;42(2):237-245. doi: 10.1080/02813432.2024.2305929. Epub 2024 Jan 24.

Reference Type DERIVED
PMID: 38265029 (View on PubMed)

Rebnord IK, Sandvik H, Mjelle AB, Hunskaar S. Factors predicting antibiotic prescription and referral to hospital for children with respiratory symptoms: secondary analysis of a randomised controlled study at out-of-hours services in primary care. BMJ Open. 2017 Jan 17;7(1):e012992. doi: 10.1136/bmjopen-2016-012992.

Reference Type DERIVED
PMID: 28096254 (View on PubMed)

Rebnord IK, Sandvik H, Mjelle AB, Hunskaar S. Out-of-hours antibiotic prescription after screening with C reactive protein: a randomised controlled study. BMJ Open. 2016 May 12;6(5):e011231. doi: 10.1136/bmjopen-2016-011231.

Reference Type DERIVED
PMID: 27173814 (View on PubMed)

Related Links

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Other Identifiers

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NKLM 2012/1471 RV

Identifier Type: -

Identifier Source: org_study_id