Reducing Antibiotic Prescriptions for Urinary Tract Infection in Long-Term Care Facilities

NCT03715062 | Completed DMC

• 1 other identifier: 111
• Study Type: interventional
• Target: 1,491
• Locations: 1 country
• Sites: 1

Brief Summary

This cluster randomized controlled study evaluates the effect of a tailored observation, reflection and communication tool on used by long-term care facility staff on antibiotic prescription for urinary tract infection in long-term care facility residents.

Conditions

Urinary Tract Infections

Keywords

Long-term care facility; ISBAR; Communication; Antibiotics; Antibiotic stewardship

Outcome Measures

Primary Outcomes (1)

• Prescription of antibiotics for urinary tract infection

  The number of antibiotic prescriptions for urinary tract infections pr resident days

  17 weeks

Secondary Outcomes (3)

• Hospitalization

  17 weeks

• Death

  17 weeks

• Appropriate prescription of antibiotics for urinary tract infections

  17 weeks

Other Outcomes (3)

• Symptoms

  17 weeks

• Observations

  17 weeks

• Contact to doctor

  17 weeks

Study Arms (2)

Intervention group

EXPERIMENTAL

Receives education in diagnosing urinary tract infection and use of observation, reflection and communication tool.

Other: Dialogue tool

Control group

NO INTERVENTION

No intervention

Interventions

Dialogue tool OTHER

The intervention has two parts: an educational session and a dialogue tool. The educational session consists of 75 minutes of education in diagnosing urinary tract infection. The dialogue tool consists of 1) a checking box for the most important symptoms and observations for urinary tract infection 2) an algorithm to evaluate if urinary tract infection is likely based on the present symptoms and observations 3) a list of reflection points to evaluate with a collegue 4) a specialized ISBAR (communication tool) if long-term care facility staff finds it appropriate to contact the General Practicioner

Also known as: Observation, reflection and communication tool

Intervention group

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• We include only social and health helpers, social and health assistants and nurses, who have a permanent contract at the LTCF and do day- or evening shifts for the educational session. It is optional for the LTCF to use the educational material to educate LTCF staff in nightshifts. However, a UTI is rarely observed and reported during the night, which is why we chose this pragmatic approach. Usually, if a UTI is suspected, the night shift will report to the day shift, who then reevaluates and contacts the GP if necessary. We also target the permanently employed, as they are the majority of employees with nursing responsibilities and set the standard for the temporary staff.
• All incidents of suspected UTI in LTCF residents or antibiotic prescriptions for UTI must be registered. All registrations must be made on LTCF residents above 65 years of age and with a permanent address at the LTCF, otherwise the incidence of ASB is different than assumed in preparing the intervention.

You may not qualify if:

• None

Sponsors & Collaborators

• Research Unit Of General Practice, Copenhagen: lead
• Ministry of the Interior and Health, Denmark: collaborator
• Velux Fonden: collaborator
• Herlev Hospital: collaborator

Study Sites (1)

Research Unit of General Practice

Copenhagen, 1014, Denmark

Location

Related Publications (2)

• Arnold SH, Nygaard Jensen J, Bjerrum L, Siersma V, Winther Bang C, Brostrom Kousgaard M, Holm A. Effectiveness of a tailored intervention to reduce antibiotics for urinary tract infections in nursing home residents: a cluster, randomised controlled trial. Lancet Infect Dis. 2021 Nov;21(11):1549-1556. doi: 10.1016/S1473-3099(21)00001-3. Epub 2021 Jul 22.

  PMID: 34303417 DERIVED

• Arnold SH, Jensen JN, Kousgaard MB, Siersma V, Bjerrum L, Holm A. Reducing Antibiotic Prescriptions for Urinary Tract Infection in Nursing Homes Using a Complex Tailored Intervention Targeting Nursing Home Staff: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc. 2020 May 8;9(5):e17710. doi: 10.2196/17710.

  PMID: 32383679 DERIVED

MeSH Terms

Conditions

Urinary Tract Infections; Communication

Interventions

Observation

Condition Hierarchy (Ancestors)

Infections; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Behavior

Intervention Hierarchy (Ancestors)

Methods; Investigative Techniques

Study Officials

• Lars Bjerrum, MD, PHD

  Professor

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Statistical analysis is masked.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Medical Doctor

Model Details: Cluster randomized controlled study, where each Long-term care facility is one cluster.

Study Record Dates

• First Submitted: October 5, 2018
• First Posted: October 22, 2018
• Study Start: December 1, 2018
• Primary Completion: March 31, 2019
• Study Completion: March 31, 2019
• Last Updated: June 4, 2019

Record last verified: 2019-05

Data Sharing

• IPD Sharing: Will not share

Locations

DK (1)