Community Interventions for Tackling Antimicrobial Resistance in Ghana

NCT ID: NCT07284914

Last Updated: 2025-12-16

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

285 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-04-30

Study Completion Date

2026-12-31

Brief Summary

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This research project aims to test the effect of two interventions targeted to community pharmacies in the Greater Accra region, Ghana, on antibiotics dispensing rates. The general goal is to inform the design of future policies to address the rising threat of antimicrobial resistance.

Detailed Description

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Interventions that discourage community pharmacies from providing antibiotics without proper diagnosis and a physician's prescription are critically needed in low- and middle-income countries in order to address the rising threat of antimicrobial resistance. In this study, we will test the effect of two interventions targeted to community pharmacies in the Greater Accra region of Ghana. We will conduct a baseline survey, followed by visits by standardized patients (SPs). We will then implement the interventions (described below) and assess the outcomes again using SPs.

The study has 4 key objectives:

Objective 1. Assess the effect of two behavioral interventions targeted to community pharmacies on antibiotics dispensing rates. We randomly assign 285 pharmacies in Greater Accra 1:1:1 into one of three arms: 1) Control, 2) Individualized Feedback, and 3) Legal Reminder. In the Individualized Feedback arm, we use information from the first visits to provide customized feedback to the pharmacies. In the Legal Reminder arm, we provide a letter from the Ghana authorities emphasizing that providing antibiotics without a physician prescription is against the law.

Objective 2. Assess the extent of know-do gap in antibiotics dispensing behavior among community pharmacies. We compare self-reported data from a baseline survey and the one obtained from SP visits to assess the gap between what the pharmacies know and what they do in practice.

Objective 3. Examine the effect of reduced pressure from patients for antibiotics on pharmacies' dispensing behavior. The two demand variations we will test are the following: 1) Patient asks for a medicine (normal demand pressure), 2) Patient explicitly says that they would prefer not to take antibiotics and mention that they do not have a physician prescription and that their condition appears to be viral (reduced demand pressure).

Objective 4. Assess differential effects of the two interventions and reduced demand pressure across patient's age.

Conditions

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Upper Resp Tract Infection

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Community pharmacies will be randomized into 3 arms (control, Individualized Feedback, and Legal Reminder). Pharmacies in each arm will be visited by standardized patients under 4 scenarios (low demand-young patient; low demand-old patient, normal demand-young patient, normal demand-old patient).
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Control

No intervention

Group Type NO_INTERVENTION

No interventions assigned to this group

Individualized Feedback

Pharmacies receive customized feedback on their antibiotics dispensing behavior.

Group Type EXPERIMENTAL

Individualized Feedback

Intervention Type BEHAVIORAL

We use information from the baseline visits (e.g., on whether they give antibiotics without a prescription and the time they spend with patients) to provide customized feedback to the pharmacies.

Legal Reminder

Pharmacies receive letter from the authorities in Ghana emphasizing that providing antibiotics without a physician prescription is against the law.

Group Type EXPERIMENTAL

Legal Reminder

Intervention Type BEHAVIORAL

We provide a letter from the authorities in Ghana emphasizing that providing antibiotics without a physician prescription is against the law.

Interventions

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Individualized Feedback

We use information from the baseline visits (e.g., on whether they give antibiotics without a prescription and the time they spend with patients) to provide customized feedback to the pharmacies.

Intervention Type BEHAVIORAL

Legal Reminder

We provide a letter from the authorities in Ghana emphasizing that providing antibiotics without a physician prescription is against the law.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Operating within the Greater Accra region of Ghana
* Registered with Ghana Pharmacy Council
* "Stand-alone", i.e., not affiliated or next to a hospital

Exclusion Criteria

* Operating only outside the Greater Accra region of Ghana
* Not registered with Ghana Pharmacy Council
* Hospital pharmacy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Ghana

OTHER

Sponsor Role collaborator

Penn State University

OTHER

Sponsor Role lead

Responsible Party

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Yubraj Acharya, Ph.D.

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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University of Ghana, Regional Institute for Population Studies

Legon, , Ghana

Site Status

Countries

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Ghana

Central Contacts

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Yubraj Acharya, Ph.D.

Role: CONTACT

814-865-6898

Facility Contacts

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Adriana Biney, Ph.D.

Role: primary

0302 906 800

Other Identifiers

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102725

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

STUDY00026602

Identifier Type: -

Identifier Source: org_study_id