Clinical trial NCT00105248: Patient Centered Communication Training to Reduce Antibiotic Use in Acute Respiratory Tract Infections
Official title: Multidimensional Intervention Program to Reduce Antibiotic Prescriptions for Acute Respiratory Tract Infections in Adults: a Randomized Controlled Trial in Primary Care
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Respiratory Tract Infections
Keywords: acute repiratory infections
antibiotic therapy
patient-centred communication
randomized controlled trial
Lead sponsor: University Hospital, Basel, Switzerland
Sponsor class: OTHER
Collaborators: name: Basel Institute of Clinical Epidemiology (BICE)
name: Swiss National Science Foundation
name: Novartis
First posted: 2005-03-11
Enrollment: 900
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL

Brief summary: The purpose of this study is to evaluate the effectiveness of a short training program for general practitioners in patient-centered communication to reduce antibiotic prescription for acute respiratory tract infections (ARTI).

Detailed description: Acute respiratory tract infections (ARTI) constitute the most frequent reason for seeking ambulatory care and for the prescription of antibiotics, despite the mostly viral origin of ARTI. Antibiotic prescriptions for ARTI increase unnecessary drug expenditures and are the main reason for increasing drug resistance of common bacteria. Evidence from intervention studies shows that merely providing physicians with guidelines and educational material for the management of acute respiratory tract infections is not enough to reduce antibiotic prescriptions for these conditions. The main reasons for antibiotic prescription in ARTI are non-medical and related to the physician patient relationship, patients' expectations and beliefs about the benefit of antibiotics. Therefore patient-centered communication could be a promising approach to reduce the rate of antibiotic prescription in ambulatory care.

Comparison: General practitioners (GPs) trained in patient-centered communication in addition to evidence-based guidelines for diagnosis and treatment of ARTI compared to GPs just introduced to evidence-based guidelines.

Eligibility criteria: Inclusion Criteria:

* 18 years or older
* Symptoms of an acute respiratory tract infection for \>1 and \<28 days

Exclusion Criteria:

* Patients without informed consent
* Not fluent in German
* Patients with a psychiatric disorder
* Patients with a recurrent respiratory system infection with antibiotic treatment in the previous 4 weeks

Primary outcomes:
measure: Up-take of antibiotic prescription confirmed by pharmacists within 2 weeks following the initial consultation
Secondary outcomes:
measure: Patient satisfaction with consultation (on validated scale)
measure: patient enablement (on validated scale)
measure: days with restriction from ARTI within 14 days initial consultation
measure: side effects from medication
measure: re-consultation rates
measure: days off from work
Other outcomes:
Locations:
city: Basel
country: Switzerland
facility: Basel institute for clinical epidemiology
Study officials:
affiliation: University Hospital, Basel, Switzerland
name: Heiner Bucher, Prof.
role: PRINCIPAL_INVESTIGATOR
References: