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Improving Antibiotic Use in Urgent Care Facilities (SCORE_UC)

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ClinicalTrials.gov Identifier: NCT03932708
Recruitment Status : Not yet recruiting
First Posted : May 1, 2019
Last Update Posted : May 1, 2019
Sponsor:
Collaborator:
Centers for Disease Control and Prevention
Information provided by (Responsible Party):
Intermountain Health Care, Inc.

Brief Summary:
This study will implement a comprehensive outpatient stewardship program targeting a large network of Urgent Care (UC) clinics within Intermountain Helathcare.

Condition or disease Intervention/treatment Phase
Antibiotic Side Effect Behavioral Changes Behavioral: CDC Core Elements of Outpatient Stewardship Not Applicable

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 700000 participants
Intervention Model: Single Group Assignment
Intervention Model Description: This is a before/after study design.
Masking: None (Open Label)
Primary Purpose: Health Services Research
Official Title: Improving Antibiotic Use in Urgent Care Facilities Through Implementation and Evaluation of Core Elements of Outpatient Antibiotic Stewardship
Estimated Study Start Date : July 1, 2019
Estimated Primary Completion Date : June 30, 2020
Estimated Study Completion Date : June 30, 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Antibiotics

Arm Intervention/treatment
Experimental: Urgent Care Antibiotic Stewardship Intervention
All 38 urgent care clinics will implement CDC Core Elements of outpatient antibiotic stewardship as described above.
Behavioral: CDC Core Elements of Outpatient Stewardship
The intervention is described above and includes components of leadership, action of policy and practice, tracking and reporting, and education and expertise.




Primary Outcome Measures :
  1. Antibiotic prescribing for respiratory encounters measured at the encounter level [ Time Frame: Intervention period is one year ]
    Respiratory encounters are defined as an urgent care encounter for any ICD10 defined respiratory condition, excluding encounters with concomitant other infectious diseases codes.


Secondary Outcome Measures :
  1. Antibiotic prescribing appropriateness in respiratory encounters [ Time Frame: Intervention period is one year ]
    The secondary outcome of antibiotic appropriateness will also be measured at the encounter level and will be estimated two ways: (i) in terms of rate of guideline-recommended antibiotics among selected respiratory diagnoses, and (ii) in terms of rate of antibiotic prescribing among respiratory diagnoses where no prescribing should occur (i.e., rate of "inappropriate" antibiotics).

  2. Diagnostic shifting [ Time Frame: Intervention period is one year ]
    The secondary outcome of diagnostic shifting will be measured at the provider level and characterize changes in the types of diagnoses used during respiratory encounters.

  3. Patient satisfaction [ Time Frame: Intervention period is one year ]
    As data availability allows, a secondary outcome of patient satisfaction will be measured at the patient encounter level in terms of a validated, patient satisfaction score. Patient satisfaction will be assessed using the "rate your provider" question. This question asks patients to rate their provider on a scale of 1 - 10 (1 being the worst, 10 being the best). Patient satisfaction scores will be explored in patients that receive antibiotics for tier 2 and 3 respiratory conditions and those that do not receive antibiotics for tier 2 and 3 respiratory conditions.



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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Intermountain Healthcare "InstaCare" Clinics
  • Intermountain Healthcare "KidsCare" Clinics
  • Intermountain Healthcare "ConnectCare"

Exclusion Criteria:

  • Intermountain Healthcare Hospitals and Medical Centers
  • All non-Intermountain Healthcare urgent care clinics

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 ClinicalTrials.gov identifier (NCT number): NCT03932708


Contacts
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Contact: Eddie Stenehjem, MD 801-507-7781 eddie.stenehjem@imail.org
Contact: Carlos Barbagelata, MS 801-507-4607 carlos.barbagelata@imail.org

Locations
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United States, Utah
Intermountain Medical Center Not yet recruiting
Murray, Utah, United States, 84017
Contact: Valerie Aston    801-507-4606    valerie.aston@imail.org   
Contact: Carlos Barbagelata, MS    801-507-4607    carlos.barbagelata@imail.org   
Principal Investigator: Eddie Stenehjem, MD         
Sponsors and Collaborators
Intermountain Health Care, Inc.
Centers for Disease Control and Prevention
Investigators
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Principal Investigator: Eddie Stenehjem, MD Intermountain Health Care, Inc.

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Responsible Party: Intermountain Health Care, Inc.
ClinicalTrials.gov Identifier: NCT03932708     History of Changes
Other Study ID Numbers: 1050982
First Posted: May 1, 2019    Key Record Dates
Last Update Posted: May 1, 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 Intermountain Health Care, Inc.:
Antibiotic Stewardship
Outpatient Antibiotic Stewardship
Urgent Care

Additional relevant MeSH terms:
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Problem Behavior
Behavioral Symptoms
Anti-Bacterial Agents
Antibiotics, Antitubercular
Anti-Infective Agents
Antitubercular Agents