Demonstration of Near Zero Antibiotic Prescribing for Acute Bronchitis

NCT01240174 | Completed

• 1 other identifier: 2010P001247
• Study Type: interventional
• Target: 400
• Locations: 1 country
• Sites: 1

Brief Summary

Studies show, guidelines state, and performance measures assert that antibiotic prescribing for uncomplicated acute bronchitis is inappropriate. However, clinicians prescribe antimicrobials in over 60% of the 22.5 million acute bronchitis visits in the United States each year. Previous successful interventions have only reduced the antimicrobial prescribing rate to 40% or 50%. It is unknown if the antimicrobial prescribing rate for acute bronchitis can be brought to near zero percent in actual practice while maintaining patient safety and satisfaction. The goal of this study is to develop an Electronic Health Record (EHR)-integrated algorithm for the diagnosis and treatment of adults with acute bronchitis with a goal of reducing the antibiotic prescribing rate to near zero percent.

Conditions

Bronchitis; Cough

Keywords

Antibiotic; Antimicrobial; Prescribing; Cough; Acute Bronchitis

Outcome Measures

Primary Outcomes (1)

• Antibiotic prescribing rate

  The antibiotic prescribing rate for patients with acute bronchitis

  30 days

Secondary Outcomes (5)

• Patient symptoms

  21 days

• Patient satisfaction

  21 days

• Patient safety

  30 days

• Healthcare costs

  30 days

• The capture and description of the components that had the greatest effect on the antimicrobial prescribing rate

  3 years

Study Arms (1)

Intervention Arm

OTHER

Single arm in the study of doctors receiving feedback about their antibiotic prescribing rate for acute bronchitis.

Behavioral: Demonstration of near zero antibiotic prescribing for patients with acute bronchitis

Interventions

Demonstration of near zero antibiotic prescribing for patients with acute bronchitis BEHAVIORAL

A controlled, continuously-monitored, implementation of an EHR-integrated diagnosis and treatment algorithm for acute bronchitis in a large, diverse primary care practice.

Intervention Arm

Eligibility Criteria

• Age: 18 Years - 64 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• first visit in 30 days, age 18-64, has a cough of less than 3 weeks duration

You may not qualify if:

• infiltrate on chest x-ray, has chronic lung disease

Sponsors & Collaborators

• Brigham and Women's Hospital: lead
• Agency for Healthcare Research and Quality (AHRQ): collaborator

Study Sites (1)

Brigham and Women's Hospital Jen Center for Primary Care

Boston, Massachusetts, 02115, United States

Location

MeSH Terms

Conditions

Bronchitis; Cough

Condition Hierarchy (Ancestors)

Respiratory Tract Infections; Infections; Bronchial Diseases; Respiratory Tract Diseases; Lung Diseases, Obstructive; Lung Diseases; Respiration Disorders; Signs and Symptoms, Respiratory; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Jeffrey A Linder, MD, MPH

  Brigham and Women's Hospital, Harvard Medical School

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Physician

Study Record Dates

• First Submitted: November 10, 2010
• First Posted: November 15, 2010
• Study Start: March 1, 2011
• Primary Completion: June 1, 2014
• Study Completion: July 1, 2014
• Last Updated: February 1, 2017

Record last verified: 2017-01

Locations

US (1)