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

This study has been completed.
Sponsor:
Collaborators:
University of Aberdeen
Newcastle University
University of Southampton
Chief Scientist Office of the Scottish Government
Scottish Primary Care Research Network
Scottish School of Primary Care
Information provided by (Responsible Party):
Shaun Treweek, University of Dundee
ClinicalTrials.gov Identifier:
NCT01206738
First received: September 21, 2010
Last updated: July 22, 2014
Last verified: July 2014
  Purpose
  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?

Condition Intervention
Antibiotic Prescribing by GPs for URTI.
Behavioral: Persuasive communication
Behavioral: Action plan
Behavioral: General intervention

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Outcomes Assessor)
Primary Purpose: Health Services Research
Official Title: Developing and Evaluating Interventions to Reduce Inappropriate Prescribing by General Practitioners of Antibiotics for Upper Respiratory Tract Infections: an RCT to Compare Paper-based and Web-based Modelling Experiments

Resource links provided by NLM:


Further study details as provided by University of Dundee:

Primary Outcome Measures:
  • Number of Simulated Scenarios Where an Antibiotic Was Not Prescribed [ Time Frame: Immediately after completion of questionnaire ] [ Designated as safety issue: No ]
    Eight simulated clinical scenarios where presented to the GP and he/she was asked whether an antibiotic should be prescribed. The outcome measures was the number of scenarios where an antibiotic was not prescribed.

  • Email vs Postal Recruitment: Number of GPs Completing the First Questionnaire [ Time Frame: 27/1/20111 - 15/5/2011 ] [ Designated as safety issue: No ]
    GPs were randomly allocated to receive their invitation to take part by email or by post. Outcome measure was proportion of GPs responding by completing the first questionnaire


Enrollment: 270
Study Start Date: November 2010
Study Completion Date: September 2012
Primary Completion Date: May 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Persuasive communication
The persuasive intervention aimed to reinforce the GP's beliefs about the positive consequences of managing sore throat without prescribing antibiotics.
Behavioral: Persuasive communication
The persuasive intervention aimed to reinforce the GP's beliefs about the positive consequences of managing sore throat without prescribing antibiotics.
Experimental: 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
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
Active Comparator: General information
No additional information was provided; the general information was the information already available to GPs about antibiotic prescribing.
Behavioral: General intervention
No additional information was provided; the general information was the information already available to GPs about antibiotic prescribing.

Detailed Description:

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.

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • GPs in Scotland.

Exclusion Criteria:

  • Unable to obtain both an email address and a postal address for the GP.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01206738

Locations
United Kingdom
University of Dundee
Dundee, Tayside, United Kingdom, DD1 4HN
Sponsors and Collaborators
University of Dundee
University of Aberdeen
Newcastle University
University of Southampton
Chief Scientist Office of the Scottish Government
Scottish Primary Care Research Network
Scottish School of Primary Care
Investigators
Principal Investigator: Shaun Treweek, PhD University of Dundee
  More Information

Publications:
Responsible Party: Shaun Treweek, Senior Lecturer, University of Dundee
ClinicalTrials.gov Identifier: NCT01206738     History of Changes
Other Study ID Numbers: 2010PS10, CZH/4/610
Study First Received: September 21, 2010
Results First Received: January 30, 2014
Last Updated: July 22, 2014
Health Authority: United Kingdom: Research Ethics Committee
United Kingdom: National Health Service

Additional relevant MeSH terms:
Respiratory Tract Infections
Infection
Respiratory Tract Diseases
Anti-Bacterial Agents
Antibiotics, Antitubercular
Anti-Infective Agents
Therapeutic Uses
Pharmacologic Actions
Antitubercular Agents

ClinicalTrials.gov processed this record on September 30, 2014