Randomized Controlled Study to Incentivize Doctors for Appropriate Use of Medical Care in NL

NCT03488121 | Withdrawn

• 1 other identifier: 2017.282
• Study Type: interventional
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

Choosing Wisely Canada is a campaign for promoting appropriate use of medical services to reduce unnecessary prescribing and unnecessary diagnostic tests. Its success depends on physicians' uptake of the campaign's recommendations on appropriate use of health care. This study will conduct a cluster-randomized controlled trial to evaluate the effects of two low-cost incentives for physicians to promote their uptake of Choosing Wisely recommendations in Newfoundland and Labrador (NL). The first incentive involves placing a motivational poster in a physician's examination room. These posters will contain motivational messages about the important roles that doctors and patients can play in reducing unnecessary care. The second incentive involves sending thank-you letters to physicians to recognize their contribution in reducing unnecessary care, and thus, 'nudge' them into following recommendations. The study will evaluate the effects of the incentives on physicians' prescribing of antibiotics and serum ferritin tests. Potential cost savings of implementing the two incentives will also be estimated.

Conditions

Prescription Practices of Family Physicians in NL

Outcome Measures

Primary Outcomes (2)

• Rate of antibiotic prescriptions

  Rate of antibiotic prescriptions will be calculated as the number of antibiotic prescriptions per patient.

  12 months

• Rate of ordering of serum ferritin tests

  Rate of serum ferritin tests ordered will be calculated as the number of serum ferritin tests ordered per patient.

  12 months

Secondary Outcomes (1)

• Cost savings from implementing the incentives

  12 months

Study Arms (4)

Poster Only

EXPERIMENTAL

This arm will only receive motivational posters.

Behavioral: Poster

Thank-you Letter Only

EXPERIMENTAL

This arm will only receive thank-you letters.

Behavioral: Thank-you Letter

Double Incentive

EXPERIMENTAL

This arm will receive both motivational posters and thank-you letters.

Behavioral: Poster; Behavioral: Thank-you Letter

Control

NO INTERVENTION

This arm will not receive any intervention.

Interventions

Poster BEHAVIORAL

Posters contain inspirational messages and pictures highlighting the important and unique roles that patients and physicians can play in reducing unnecessary care and health care costs. These posters will be placed in physician offices.

Double Incentive; Poster Only

Thank-you Letter BEHAVIORAL

Physicians will be sent thank-you letters containing changes in the rates of antibiotics and serum ferritin tests ordered since introduction of Choosing Wisely NL and a thank-you message from the NL Medical Association.

Double Incentive; Thank-you Letter Only

Eligibility Criteria

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

You may qualify if:

• All Fee-For-Service family physicians registered with the NL Medical Association

You may not qualify if:

• Salary based family physicians

Sponsors & Collaborators

• Memorial University of Newfoundland: lead

Study Sites (1)

School of Pharmacy, Memorial University of Newfoundland

St. John's, Newfoundland and Labrador, A1B 3V6, Canada

Location

Study Officials

• Hai Nguyen, PhD

  Memorial University of Newfoundland

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: March 28, 2018
• First Posted: April 4, 2018
• Study Start: September 1, 2018
• Primary Completion: May 31, 2020
• Study Completion: May 31, 2020
• Last Updated: September 10, 2022

Record last verified: 2018-09

Locations

CA (1)