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Better Antibiotic Prescribing Through Action Research (BAbAR)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT03082521
Recruitment Status : Enrolling by invitation
First Posted : March 17, 2017
Last Update Posted : April 29, 2019
Information provided by (Responsible Party):
Annelies Colliers, Universiteit Antwerpen

Brief Summary:
This PAR (participatory action research) study to improve antibiotic prescribing quality in a GPC (general practitioner cooperative) during OOH-care (out-of-hours-care) uses a mixed methods approach using qualitative as well as quantitative techniques. In a first exploratory phase we will work on partnership development and mapping the existing issues. In a second phase the focus will be on facilitating change and implementing interventions through PDSA (plan do study act) cycles. In a third phase outcomes on prescribing quality during and outside office hours will be evaluated. Equally important is the process evaluation and theory building on improving antibiotic prescribing through PAR.

Condition or disease Intervention/treatment
Infectious Disease Behavioral: Improving the antibiotic prescribing quality

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Study Type : Observational [Patient Registry]
Estimated Enrollment : 170 participants
Observational Model: Other
Time Perspective: Prospective
Target Follow-Up Duration: 4 Years
Official Title: Better Antibiotic Prescribing Through Action Research
Actual Study Start Date : April 1, 2017
Estimated Primary Completion Date : March 15, 2021
Estimated Study Completion Date : October 1, 2023

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Antibiotics

Intervention Details:
  • Behavioral: Improving the antibiotic prescribing quality
    The goal is to improve the antibiotic prescribing quality of GPs in a GPC by setting up a participatory action research. The interventions will be co-designed with the GPs.

Primary Outcome Measures :
  1. Interview study [ Time Frame: year 1 ]
    Semi-structured interview with the stakeholders on the experiences of prescribing antibiotics in OOH care and the willingness to participate in PAR.

  2. Antibiotic prescribing feedback using antibiotic prescribing quality indicators [ Time Frame: year 1 ]

    Using antibiotic prescribing quality indicators (APQI) feedback on the antibiotic prescription rates of the GPC will be generated. For the six most common indications for antibiotic prescribing (in descending order: acute bronchitis (ICPC (6) code R78), acute upper RTI (R74), cystitis/other urinary infection (UTI; U71), acute tonsillitis (R76), acute/chronic sinusitis (R75), and acute otitis media (H71)) and for pneumonia (R81) values of three valid antibiotic prescribing quality indicators (APQI)quality indicators will be calculated and fed back: (5)

    1. = the percentage of patients with age and/or gender limitation prescribed an antibiotic;
    2. = a. and receiving the guideline recommended antibiotic;
    3. = a and receiving quinolones.

  3. Ethnographic study: explanatory and descriptive approach of observations, descriptions and interpretation of the phenomenon of prescribing antibiotics in OOH care [ Time Frame: year 2 ]
    Observations of consultations to get a better understanding of the context , difficulties, clinical issues, etc. of prescribing antibiotics in OOH care.

  4. Focus groups (descriptative & interpretative) & description of PDSA cycles on developing and implementing interventions on antibiotic prescribing in OOH care [ Time Frame: year 3 ]

    Qualitative and quantitative results of phase 1 will be fedback to the group of GPs. In reflective peer group sessions the issues and problems will be explored and interventions will be designed taking into account previous work.

    The implemented interventions and changes will be studied based on both outcome as process indicators. ESACs' Antibiotic Prescribing Quality Indicators (APQI) will be used to assess quality of antibiotic prescribing. Pocess indicators will depend on the chosen interventions.

  5. Process evaluation and sociological meso-theory building of PAR in the case of improving antibiotic prescribing behaviour in a GPC [ Time Frame: year 4 ]
    Evaluation of the study, theory building on optimising antibiotic use with PAR. Study of group-level interactions, descriptive.

Secondary Outcome Measures :
  1. Use of Antibiotics (quantity, type, use of broad-spectrum antibiotics,etc.) in daytime care [ Time Frame: year 5 ]
    The use of antiobiotics during office hours to assess any spill over effect of PAR in OOH-care.

Information from the National Library of Medicine

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, Learn About Clinical Studies.

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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
General practitioners within a general practitioner cooperative during out-of-hours care.

Inclusion Criteria:

  • GPs working in the GPC

Exclusion Criteria:

  • /

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT03082521

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GPC Brabo
Antwerp, Belgium
Sponsors and Collaborators
Universiteit Antwerpen
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Study Chair: Samuel Coenen, MD, PhD Universiteit Antwerpen
Study Chair: Sibyl Anthierens, PhD Universiteit Antwerpen
Additional Information:

Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Annelies Colliers, Principal Investigator, Universiteit Antwerpen Identifier: NCT03082521    
Other Study ID Numbers: BAbAR
First Posted: March 17, 2017    Key Record Dates
Last Update Posted: April 29, 2019
Last Verified: April 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Annelies Colliers, Universiteit Antwerpen:
After hours care; Primary care; Antibiotics; Action Research
Additional relevant MeSH terms:
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Communicable Diseases
Anti-Bacterial Agents
Anti-Infective Agents