Routine Prescription Feedback and Peer Comparison to Lower Antibiotic Prescriptions in Primary Care

NCT01773824 | Completed

• 1 other identifier: USB-2012-074
• Study Type: interventional
• Target: 2,900
• Locations: 1 country
• Sites: 1

Brief Summary

To evaluate the effect of a continuous postal and web-based feedback and peer comparison system of individual antibiotic prescription rates on the prescription behaviour of primary care physicians in Switzerland.

Conditions

Upper Respiratory Tract Infections; Urinary Tract Infections

Keywords

antibiotic; prescription rate

Outcome Measures

Primary Outcomes (1)

• Prescription rate of antibiotics as defined daily doses (DDD) per 100 consultations

  at 12 and 24 months

Secondary Outcomes (4)

• Costs-savings from the intervention

  at 24 months

• Rate of physicians rating that the continuous update on antibiotic prescription data is useful

  at 24 months

• Percentage of prescriptions fulfilling disease-specific quality indicators for outpatient antibiotic criteria by the European Surveillance of Antimicrobial Consumption (ESAC).

  at 24 months

• Number of logins into the web-application

  at 24 months

Study Arms (2)

No feedback

OTHER

Physicians in the control group will only be monitored for their antibiotic prescription rates (Physicians are unaware of the trial).

Behavioral: No Feedback

Antibiotic prescription feedback

EXPERIMENTAL

Physicians receive quarterly electronic feedback on their antibiotic prescriptions

Behavioral: Antibiotic prescription feedback

Interventions

Antibiotic prescription feedback BEHAVIORAL

Monthly postal and electronic feedback on antibiotic prescription rates

Also known as: Active physician benchmarking

Antibiotic prescription feedback

No Feedback BEHAVIORAL

Physicians in the control group will only be monitored for their antibiotic prescription rates (Physicians are unaware of the trial)

Also known as: Controls

No feedback

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Board certified physicians with a certificate from the Swiss Medical Association (Facharzttitel' General Internal Medicine, Subspecialities in Internal Medicine, Paediatrics) with an own ZAHLSTELLENREGISTER NUMBER (Konkordatsnummer).
• At least 100 patients enlisted with the specified social health insurance providers (SANTÉSUISSE DATENPOOL AND TARIFPOOL). (to avoid classifying physicians as high prescribers who only see a small number of patients and describe antibiotics to many of them)
• Prescription-rates of antibiotics (DDD per 100 consultations) - that are prescribed to patients enlisted with the specified social health insurance providers (SANTÉSUISSE TARIFPOOL)
• are in the upper median of the prescription number distribution in the year prior to the start of the trial.

You may not qualify if:

• Physicians with no own "Zentralstellenregister" (ZSR) number (practice fellows or substitutes, medical trainees in general practices).
• Physicians working in institutions without own but with institutional ZSR NUMBER (ambulatory care facilities of University Hospitals, permanence, practices or Health Maintenance Organisation (HMO) with group ZSR number).

Sponsors & Collaborators

• University Hospital, Basel, Switzerland: lead
• Swiss National Science Foundation: collaborator

Study Sites (1)

Switzerland

Basel, Switzerland

Location

Related Publications (2)

• Hemkens LG, Saccilotto R, Reyes SL, Glinz D, Zumbrunn T, Grolimund O, Gloy V, Raatz H, Widmer A, Zeller A, Bucher HC. Personalized Prescription Feedback Using Routinely Collected Data to Reduce Antibiotic Use in Primary Care: A Randomized Clinical Trial. JAMA Intern Med. 2017 Feb 1;177(2):176-183. doi: 10.1001/jamainternmed.2016.8040.

  PMID: 28027333 DERIVED

• Hemkens LG, Saccilotto R, Reyes SL, Glinz D, Zumbrunn T, Grolimund O, Gloy V, Raatz H, Widmer A, Zeller A, Bucher HC. Personalized prescription feedback to reduce antibiotic overuse in primary care: rationale and design of a nationwide pragmatic randomized trial. BMC Infect Dis. 2016 Aug 17;16:421. doi: 10.1186/s12879-016-1739-0.

  PMID: 27530528 DERIVED

Related Links

• Institut für Hausarztmedizin der Universität Basel
• Swiss Society for Nosocomial Infections

MeSH Terms

Conditions

Respiratory Tract Infections; Urinary Tract Infections

Condition Hierarchy (Ancestors)

Infections; Respiratory Tract Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases

Study Officials

• Heiner C Bucher, Prof Dr med

  Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel

  PRINCIPAL INVESTIGATOR

• Andreas Widmer, Prof Dr med

  Klinik für Infektiologie und Spitalhygiene, University Hospital Basel

  PRINCIPAL INVESTIGATOR

• Andreas Zeller, PD Dr med

  Institut für Hausarztmedizin, University of Basel

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 24, 2012
• First Posted: January 23, 2013
• Study Start: October 1, 2013
• Primary Completion: December 1, 2015
• Study Completion: December 1, 2015
• Last Updated: May 12, 2016

Record last verified: 2016-05

Locations

CH (1)