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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

September 21, 2010
July 22, 2014
November 2010
May 2012   (final data collection date for primary outcome measure)
  • 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
  • Web-based IME: Behavioural intention and behavioural simulation [ Designated as safety issue: No ]
  • Email vs postal recruitment: number of GPs completing the first questionnaire [ Designated as safety issue: No ]
Complete list of historical versions of study NCT01206738 on ClinicalTrials.gov Archive Site
Not Provided
Not Provided
Not Provided
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Developing and Evaluating Interventions to Reduce Inappropriate Prescribing of Antibiotics in Primary Care
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
  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?

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.

Interventional
Not Provided
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Outcomes Assessor)
Primary Purpose: Health Services Research
Antibiotic Prescribing by GPs for URTI.
  • Behavioral: Persuasive communication
    The persuasive intervention aimed to reinforce the GP's beliefs about the positive consequences of managing sore throat without prescribing antibiotics.
  • 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
  • Behavioral: General intervention
    No additional information was provided; the general information was the information already available to GPs about antibiotic prescribing.
  • Experimental: Persuasive communication
    The persuasive intervention aimed to reinforce the GP's beliefs about the positive consequences of managing sore throat without prescribing antibiotics.
    Intervention: Behavioral: Persuasive communication
  • 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
    Intervention: Behavioral: Action plan
  • Active Comparator: General information
    No additional information was provided; the general information was the information already available to GPs about antibiotic prescribing.
    Intervention: Behavioral: General intervention

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
270
September 2012
May 2012   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • GPs in Scotland.

Exclusion Criteria:

  • Unable to obtain both an email address and a postal address for the GP.
Both
Not Provided
No
Contact information is only displayed when the study is recruiting subjects
United Kingdom
 
NCT01206738
2010PS10, CZH/4/610
No
Shaun Treweek, University of Dundee
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
Principal Investigator: Shaun Treweek, PhD University of Dundee
University of Dundee
July 2014

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP