Evaluation of Therapeutic Initiative's Cystitis Portrait and Therapeutics Letter
Impact Evaluation of the Therapeutic Initiative's Uncomplicated Acute Cystitis Personalized Portrait and Therapeutics Letter
1 other identifier
interventional
5,073
1 country
1
Brief Summary
The goal of this randomized trial is to test the impact of mailing personalized prescribing Portraits (an audit and feedback tool) and Therapeutics Letters (a reference document) to physicians on first-line prescribing to patients with uncomplicated urinary tract infection (UTI) . The main question this study aims to answer is: • To what extent can personal prescribing feedback Portraits and Therapeutics Letters have an effect on how physicians prescribe antibiotics for uncomplicated UTI? Approximately 5,000 British Columbian Family Practitioners (FP's) have been randomly divided into three groups, and each group received the Portrait at different times. To help ascertain the possible impact of Portraits, pooled data on first-line prescribing for uncomplicated UTI by FP's who received the Portrait at an early time point (September 23, 2021) will be compared to that of those who received a Portrait at a delayed time point (March 28, 2022). Researchers will compare prescribing data from these groups to see if the prescribing Portraits have had a differential impact on prescribing of antibiotics for uncomplicated UTI.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Sep 2021
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
September 23, 2021
CompletedPrimary Completion
Last participant's last visit for primary outcome
September 28, 2022
CompletedStudy Completion
Last participant's last visit for all outcomes
September 28, 2022
CompletedFirst Submitted
Initial submission to the registry
February 9, 2023
CompletedFirst Posted
Study publicly available on registry
April 18, 2023
CompletedApril 18, 2023
April 1, 2023
1 year
February 9, 2023
April 4, 2023
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Monthly prescribing of Nitrofurantoin
The primary outcome is the proportion of uncomplicated acute cystitis episodes treated with nitrofurantoin.
The study period for the primary analysis is the 185 day period after the early intervention, which is from September 24, 2021 to March 28, 2022..
Secondary Outcomes (1)
Monthly prescribing of ciprofloxacin, trimethoprim-sulfamethoxazole (TMP-SMX), and other antibiotics.
The study period for the primary analysis is the 185 day period after the early intervention, which is from September 24, 2021 to March 28, 2022.
Study Arms (3)
Early Letter + Portrait Arm
EXPERIMENTALEarly Letter + Portrait Arm received a Portrait + Therapeutics Letter with the initial mailing (September 23, 2021). At the delayed mailing (March 28, 2022), Early Letter + Portrait Arm received nothing.
Delayed Control Arm
EXPERIMENTALDelayed Control Arm received nothing with the initial mailing (on September 23, 2021). At the delayed mailing (March 28, 2022), Delayed Control Arm received a Portrait +Therapeutics Letter.
Early Letter Arm
EXPERIMENTALEarly Letter Arm received a Therapeutics Letter only with the initial mailing (September 23, 2021). At the delayed mailing (March 28, 2022), Early Letter Arm received a Portrait + Therapeutics Letter
Interventions
In the context of audit and feedback interventions, Portrait is document produced by the physician organization 'Therapeutics Initiative' that provides personalized prescribing feedback for BC family physicians (FPs). Portraits are used as a practice resource tool for reflection on prescribing patterns. Each Portrait topic provides data of individual physician's prescribing practice, alongside the mean and median levels of their peers (other BC physicians), a succinct review of the best-available evidence on the topic, and recommendations for future action.
The Therapeutics Letter is a standalone publication that details identified problematic therapeutic issues in a brief, simple and practical manner. Therapeutics letters include a systematic literature review on a clinical topic, and help provide reference for the data presented in the Portraits.
Eligibility Criteria
You may qualify if:
- Physicians who are:
- i. Registered with the College of Physicians and Surgeons of B.C. (CPSBC) ii. Defined as a General Practitioner or Family Practice - Emergency Medicine according to the B.C. Ministry of Health's Medical Services Plan (MSP) with a license status of private practice, temporary license, salaried, or post graduate.
- iii. Hold a valid mailing address in B.C according to the College of Physicians and Surgeons of British Columbia's public physician information.
- iv. Had \>=100 prescriptions filled at a community pharmacy in 2020 according to PharmaNet claims.
- v. Diagnosed \>= 1 eligible patient with Uncomplicated Acute Cystitis (UAC) in 2019 or 2020 (for delay group: 2020 to 2021
You may not qualify if:
- Non-physicians, or physicians who:
- i. Were not registered with the College of Physicians and Surgeons of B.C. (CPSBC) ii. Were not classified as a General Practitioner or Family Practice - Emergency Medicine according to the B.C. Ministry of Health's Medical Services Plan (MSP) with a license status of private practice, temporary license, salaried, or post graduate.
- iii. Had an invalid mailing address in B.C according to the College of Physicians and Surgeons of British Columbia's public physician information.
- iv. Had \<=100 prescriptions filled at a community pharmacy in 2020 according to PharmaNet claims.
- v. Diagnosed \<= 1 eligible patient with Uncomplicated Acute Cystitis (UAC) in 2019 or 2020 (for delay group: 2020 to 2021
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Therapeutics Initiative - Dept of Anesthesiology, Pharmacology & Therapeutics Faculty of Medicine University of British Columbia
Vancouver, British Columbia, V6T 1Z3, Canada
Related Publications (1)
Carney G, Maclure M, Patrick DM, Otte J, Ambasta A, Thompson W, Dormuth C. Pragmatic randomised trial assessing the impact of peer comparison and therapeutic recommendations, including repetition, on antibiotic prescribing patterns of family physicians across British Columbia for uncomplicated lower urinary tract infections. BMJ Qual Saf. 2025 Apr 17;34(5):295-304. doi: 10.1136/bmjqs-2024-017296.
PMID: 39414374DERIVED
Study Officials
- PRINCIPAL INVESTIGATOR
Colin Dormuth, PhD
University of British Columbia
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- PARTICIPANT
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- SEQUENTIAL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Associate Professor
Study Record Dates
First Submitted
February 9, 2023
First Posted
April 18, 2023
Study Start
September 23, 2021
Primary Completion
September 28, 2022
Study Completion
September 28, 2022
Last Updated
April 18, 2023
Record last verified: 2023-04