NCT05385445

Brief Summary

Audit and Feedback (A\&F), a strategy aimed at promoting modified practice through performance feedback, is a method to change provider behaviour and reduce unnecessary medical services. This study aims to assess the use of A\&F to change:

  1. 1.antibiotic prescribing for viral infections
  2. 2.antipsychotic prescribing to patients with dementia
  3. 3.routine measure of vitamin D in low risk adults
  4. 4.annual screening blood tests (without direct indication by the risk profile of the patient)

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
239

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Jan 2016

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

January 1, 2016

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 1, 2017

Completed
3 years until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2019

Completed
2.3 years until next milestone

First Submitted

Initial submission to the registry

April 29, 2022

Completed
24 days until next milestone

First Posted

Study publicly available on registry

May 23, 2022

Completed
Last Updated

May 23, 2022

Status Verified

April 1, 2022

Enrollment Period

1 year

First QC Date

April 29, 2022

Last Update Submit

May 17, 2022

Conditions

DementiaViral InfectionVitamin D Deficiency

Keywords

Primary Health CareAnnual Screening

Outcome Measures

Primary Outcomes (4)

  • Change in antibiotic prescribing for upper respiratory infections that are likely viral in origins

    Investigators assessed baseline prescribing (before the intervention, 2014/2015), and compared this to during the intervention (2016/2017) and following the intervention (2018/2019)

    12 months

  • Change in prescribing of antipsychotics to treat behavioural and psychological symptoms of dementia.

    Investigators assessed baseline prescribing (before the intervention, 2014/2015), and compared this to during the intervention (2016/2017) and following the intervention (2018/2019)

    12 months

  • Change in Vitamin D laboratory testing

    Investigators assessed baseline ordering (before the intervention, 2014/2015), and compared this to during the intervention (2016/2017) and following the intervention (2018/2019)

    12 months

  • Change in PSA ordering (annual screening)

    Investigators assessed baseline ordering (before the intervention, 2014/2015), and compared this to during the intervention (2016/2017) and following the intervention (2018/2019)

    12 months

Study Arms (3)

Audit and Feedback Group 1

EXPERIMENTAL

The intervention "Group 1" received the standard feedback report with a one-page summary of the CWC recommendations of interest. Group 1 did not receive any data specific to their prescribing.

Behavioral: Audit and Feedback

Audit and Feedback Group 2

EXPERIMENTAL

Intervention "Group 2" received the standard feedback report, CWC recommendation summary and practice-specific data related to their prescribing rates for the CWC recommendations of interest, compared to rates for other providers at their clinic, in their health region and in the province.

Behavioral: Audit and Feedback

Control

NO INTERVENTION

The control group received the standard feedback report with no information related to CWC.

Interventions

Audit and FeedbackBEHAVIORAL

The investigators conducted a clustered randomized trial of primary care providers in Manitoba, Canada participating in the Manitoba Primary Care Research Network (MaPCReN) to assess the impact of Audit \& Feedback interventions to change prescribing and laboratory ordering.

Audit and Feedback Group 1Audit and Feedback Group 2

Eligibility Criteria

Sexall
Healthy VolunteersYes
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • All primary care providers participating in the Manitoba Primary Care Research Network (MaPCReN), the Manitoba practice-based network of the Canadian Primary Care Sentinel Surveillance Network.

You may not qualify if:

  • Primary care providers not participating in MaPCReN

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Manitoba, Department of Family Medicine

Winnipeg, Manitoba, R3W0A8, Canada

Location

Related Publications (2)

  • Singer A, Kosowan L, Katz A, Jolin-Dahel K, Appel K, Lix LM. Prescribing and testing by primary care providers to assess adherence to the Choosing Wisely Canada recommendations: a retrospective cohort study. CMAJ Open. 2018 Dec 10;6(4):E603-E610. doi: 10.9778/cmajo.20180053. Print 2018 Oct-Dec.

    PMID: 30530720BACKGROUND

  • Singer A, Kosowan L, Abrams EM, Katz A, Lix L, Leong K, Paige A. Implementing an audit and feedback cycle to improve adherence to the Choosing Wisely Canada recommendations: clustered randomized trail. BMC Prim Care. 2022 Nov 26;23(1):302. doi: 10.1186/s12875-022-01912-7.

    PMID: 36435746DERIVED

MeSH Terms

Conditions

DementiaVirus DiseasesVitamin D Deficiency

Condition Hierarchy (Ancestors)

Brain DiseasesCentral Nervous System DiseasesNervous System DiseasesNeurocognitive DisordersMental DisordersInfectionsAvitaminosisDeficiency DiseasesMalnutritionNutrition DisordersNutritional and Metabolic Diseases

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, CARE PROVIDER
Masking Details
Clinics were randomized to one of three groups. Electronic medical records were extracted for each group. All extracted EMR data is de-identified included the patient, provider and site details. Using a unique site identification number, sites were linked to their randomization group for analysis.
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Model Details: Cluster Randomized Trial. MaPCReN personnel randomly assigned numbers to clinics for randomization. Number of physicians practicing at each clinic was controlled during randomization. The intervention "Group 1" received the standard feedback report with a one-page summary of the CWC recommendations of interest. Group 1 did not receive any data specific to their prescribing. Intervention "Group 2" received the standard feedback report, CWC recommendation summary and practice-specific data related to their prescribing rates for the CWC recommendations of interest, compared to rates for other providers at their clinic, in their health region and in the province. The control group received the standard feedback report with no information related to CWC.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

April 29, 2022

First Posted

May 23, 2022

Study Start

January 1, 2016

Primary Completion

January 1, 2017

Study Completion

December 31, 2019

Last Updated

May 23, 2022

Record last verified: 2022-04

Locations

CA(1)