Better Antibiotic Prescribing Through Action Research

NCT03082521 | Completed

• 1 other identifier: BAbAR
• Study Type: observational
• Target: 170
• Locations: 1 country
• Sites: 1

Brief Summary

This PAR (participatory action research) study to improve antibiotic prescribing quality in a GPC (general practitioner cooperative) during OOH-care (out-of-hours-care) uses a mixed methods approach using qualitative as well as quantitative techniques. In a first exploratory phase we will work on partnership development and mapping the existing issues. In a second phase the focus will be on facilitating change and implementing interventions through PDSA (plan do study act) cycles. In a third phase outcomes on prescribing quality during and outside office hours will be evaluated. Equally important is the process evaluation and theory building on improving antibiotic prescribing through PAR.

Conditions

Infectious Disease

Keywords

After hours care; Primary care; Antibiotics; Action Research

Outcome Measures

Primary Outcomes (5)

• Interview study

  Semi-structured interview with the stakeholders on the experiences of prescribing antibiotics in OOH care and the willingness to participate in PAR.

  year 1

• Antibiotic prescribing feedback using antibiotic prescribing quality indicators

  Using antibiotic prescribing quality indicators (APQI) feedback on the antibiotic prescription rates of the GPC will be generated. For the six most common indications for antibiotic prescribing (in descending order: acute bronchitis (ICPC (6) code R78), acute upper RTI (R74), cystitis/other urinary infection (UTI; U71), acute tonsillitis (R76), acute/chronic sinusitis (R75), and acute otitis media (H71)) and for pneumonia (R81) values of three valid antibiotic prescribing quality indicators (APQI)quality indicators will be calculated and fed back: (5) 1. = the percentage of patients with age and/or gender limitation prescribed an antibiotic; 2. = a. and receiving the guideline recommended antibiotic; 3. = a and receiving quinolones.

  year 1

• Ethnographic study: explanatory and descriptive approach of observations, descriptions and interpretation of the phenomenon of prescribing antibiotics in OOH care

  Observations of consultations to get a better understanding of the context , difficulties, clinical issues, etc. of prescribing antibiotics in OOH care.

  year 2

• Focus groups (descriptative & interpretative) & description of PDSA cycles on developing and implementing interventions on antibiotic prescribing in OOH care

  Qualitative and quantitative results of phase 1 will be fedback to the group of GPs. In reflective peer group sessions the issues and problems will be explored and interventions will be designed taking into account previous work. The implemented interventions and changes will be studied based on both outcome as process indicators. ESACs' Antibiotic Prescribing Quality Indicators (APQI) will be used to assess quality of antibiotic prescribing. Pocess indicators will depend on the chosen interventions.

  year 3

• Process evaluation and sociological meso-theory building of PAR in the case of improving antibiotic prescribing behaviour in a GPC

  Evaluation of the study, theory building on optimising antibiotic use with PAR. Study of group-level interactions, descriptive.

  year 4

Secondary Outcomes (1)

• Use of Antibiotics (quantity, type, use of broad-spectrum antibiotics,etc.) in daytime care

  year 5

Interventions

Improving the antibiotic prescribing quality BEHAVIORAL

The goal is to improve the antibiotic prescribing quality of GPs in a GPC by setting up a participatory action research. The interventions will be co-designed with the GPs.

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

General practitioners within a general practitioner cooperative during out-of-hours care.

You may qualify if:

• GPs working in the GPC

Sponsors & Collaborators

• Universiteit Antwerpen: lead

Study Sites (1)

GPC Brabo

Antwerp, Belgium

Location

Related Publications (2)

• Colliers A, Coenen S, Remmen R, Philips H, Anthierens S. How do general practitioners and pharmacists experience antibiotic use in out-of-hours primary care? An exploratory qualitative interview study to inform a participatory action research project. BMJ Open. 2018 Sep 28;8(9):e023154. doi: 10.1136/bmjopen-2018-023154.

  PMID: 30269072 DERIVED

• Colliers A, Coenen S, Philips H, Remmen R, Anthierens S. Optimising the quality of antibiotic prescribing in out-of-hours primary care in Belgium: a study protocol for an action research project. BMJ Open. 2017 Oct 15;7(10):e017522. doi: 10.1136/bmjopen-2017-017522.

  PMID: 29038184 DERIVED

MeSH Terms

Conditions

Communicable Diseases

Condition Hierarchy (Ancestors)

Infections; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Samuel Coenen, MD, PhD

  Universiteit Antwerpen

  STUDY CHAIR

• Sibyl Anthierens, PhD

  Universiteit Antwerpen

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Target Duration: 4 Years
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: March 7, 2017
• First Posted: March 17, 2017
• Study Start: April 1, 2017
• Primary Completion: March 15, 2020
• Study Completion: January 1, 2022
• Last Updated: June 1, 2022

Record last verified: 2022-05

Data Sharing

• IPD Sharing: Will not share

Locations

BE (1)