Clinical trial NCT01206738: Developing and Evaluating Interventions to Reduce Inappropriate Prescribing of Antibiotics in Primary Care
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
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Antibiotic Prescribing by GPs for URTI
Lead sponsor: University of Dundee
Sponsor class: OTHER
Collaborators: name: University of Aberdeen
name: Newcastle University
name: University of Southampton
name: Chief Scientist Office of the Scottish Government
name: Scottish Primary Care Research Network
name: Scottish School of Primary Care
First posted: 2010-09-22
Enrollment: 270
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: 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?

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 criteria: Inclusion Criteria:

* GPs in Scotland.

Exclusion Criteria:

* Unable to obtain both an email address and a postal address for the GP.

Primary outcomes:
measure: Number of Simulated Scenarios Where an Antibiotic Was Not Prescribed
timeFrame: Immediately after completion of questionnaire
measure: Email vs Postal Recruitment: Number of GPs Completing the First Questionnaire
timeFrame: 27/1/20111 - 15/5/2011
Secondary outcomes:
Other outcomes:
Locations:
city: Dundee
country: United Kingdom
facility: University of Dundee
state: Tayside
Study officials:
affiliation: University of Dundee
name: Shaun Treweek, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Treweek S, Ricketts IW, Francis J, Eccles M, Bonetti D, Pitts NB, Maclennan G, Sullivan F, Jones C, Weal M, Barnett K. Developing and evaluating interventions to reduce inappropriate prescribing by general practitioners of antibiotics for upper respiratory tract infections: a randomised controlled trial to compare paper-based and web-based modelling experiments. Implement Sci. 2011 Mar 3;6:16. doi: 10.1186/1748-5908-6-16.
citation: Treweek S, Barnett K, Maclennan G, Bonetti D, Eccles MP, Francis JJ, Jones C, Pitts NB, Ricketts IW, Weal M, Sullivan F. E-mail invitations to general practitioners were as effective as postal invitations and were more efficient. J Clin Epidemiol. 2012 Jul;65(7):793-7. doi: 10.1016/j.jclinepi.2011.11.010. Epub 2012 Feb 4.
citation: Treweek S, Bonetti D, Maclennan G, Barnett K, Eccles MP, Jones C, Pitts NB, Ricketts IW, Sullivan F, Weal M, Francis JJ. Paper-based and web-based intervention modeling experiments identified the same predictors of general practitioners' antibiotic-prescribing behavior. J Clin Epidemiol. 2014 Mar;67(3):296-304. doi: 10.1016/j.jclinepi.2013.09.015. Epub 2013 Dec 31.
citation: Treweek S, Francis JJ, Bonetti D, Barnett K, Eccles MP, Hudson J, Jones C, Pitts NB, Ricketts IW, Sullivan F, Weal M, MacLennan G. A primary care Web-based Intervention Modeling Experiment replicated behavior changes seen in earlier paper-based experiment. J Clin Epidemiol. 2016 Dec;80:116-122. doi: 10.1016/j.jclinepi.2016.07.008. Epub 2016 Jul 26.