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Antibiotic prescription monitoring and feedback in primary care in Switzerland: Design and rationale of a nationwide pragmatic randomized controlled trial

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العنوان: Antibiotic prescription monitoring and feedback in primary care in Switzerland: Design and rationale of a nationwide pragmatic randomized controlled trial
المؤلفون: Andreas Kronenberg, Heiner C. Bucher, Ramon Saccilotto, Soheila Aghlmandi, Julia Bielicki, Andreas F. Widmer, Dominik Glinz, Andreas Zeller, Kimberly A. Mc Cord, Giusi Moffa
المصدر: Contemporary Clinical Trials Communications, Vol 21, Iss, Pp 100712-(2021)
Contemporary Clinical Trials Communications
Glinz, Dominik; Mc Cord, Kimberly A; Moffa, Giusi; Aghlmandi, Soheila; Saccilotto, Ramon; Zeller, Andreas; Widmer, Andreas F; Bielicki, Julia; Kronenberg, Andreas; Bucher, Heiner C (2021). Antibiotic prescription monitoring and feedback in primary care in Switzerland: Design and rationale of a nationwide pragmatic randomized controlled trial. Contemporary clinical trials communications, 21, p. 100712. Elsevier 10.1016/j.conctc.2021.100712 <http://dx.doi.org/10.1016/j.conctc.2021.100712>
بيانات النشر: Elsevier, 2021.
سنة النشر: 2021
مصطلحات موضوعية: medicine.medical_specialty, 610 Medicine & health, Primary care, Prescription feedback, Antimicrobial resistance, Antibiotic prescribing, Article, law.invention, 03 medical and health sciences, RCT, randomized controlled trials, 0302 clinical medicine, Antibiotic resistance, Randomized controlled trial, GP, general practitioners, law, Antibiotics, Health-system level, Intervention (counseling), medicine, Low-cost intervention, 030212 general & internal medicine, Medical prescription, HRO, Human Research Ordinance, Pharmacology, lcsh:R5-920, business.industry, DRG, Diagnosis Related Groups, FMH, Foederatio Medicorum Helveticorum, General Medicine, HRA, Human Research Act, Claims, Antibiotic prescription, Routinely collected patient data, 3. Good health, CI, confidence interval, Hospitalization, ZSR, Zentralregisternummer, Family medicine, EKNZ, Ethikkommission Nordwest-und Zentralschweiz, CONSORT, consolidated standards of reporting trials, 570 Life sciences, biology, Pseudonymized, business, lcsh:Medicine (General), 030217 neurology & neurosurgery
الوصف: Introduction Antibiotic consumption is highest in primary care, and antibiotic overuse furthers antimicrobial resistance. In our recently published pilot-RCT, we used monthly aggregated claims data to provide personalized antibiotic prescription feedback to general practitioners (GPs). The pilot-RCT has shown that personalized prescription feedback is a feasible and promising low-cost intervention to reduce antibiotic prescribing. Here, we describe the rationale and design of the follow-up RCT with 3426 GPs in Switzerland. We now have access to pseudonymized patient-level data from routinely collected health insurance data of the three largest health insurers in Switzerland. Methods and analysis 1713 GPs randomized to the intervention group received once evidence-based treatment guidelines at the beginning, including region-specific antibiotic resistance information from the community and personalized feedback of their antibiotic prescribing, followed by quarterly personalized prescription feedback for two years. The first and the last mailings were sent out in December 2017 and September 2019, respectively. The 1713 GPs randomized to the control group were not notified about the study and they received no guidelines and no prescription feedback. The personalized prescription feedbacks and the analyses of the primary and secondary outcomes are entirely based on pseudonymized patient-level data from routinely collected health insurance data. The primary outcome is prescribed antibiotics per 100 patient consultations during the second year of intervention. The secondary outcomes include antibiotic use during the entire two-year trial period, use of broad-spectrum antibiotics, hospitalization rates (all-cause and infection-related), and antibiotic use in different age groups. If the feedback intervention proves to be efficacious, the intervention could be continued systemwide. Ethics and dissemination The trial is publicly funded by the Swiss National Science Foundation (SNSF, grant number 407240_167066). The trial was approved by the ethics committee "Ethikkommission Nordwest-und Zentralschweiz" (EKNZ Project-ID 2017-00888). Results will be disseminated in peer-reviewed journals and international conferences.
Highlights • The randomized trial design and blinding assure internal validity. • The use of routinely collected claims data maximizes the external validity. • The control group reflects the actual practice of antibiotic prescribing in primary care. • The primary analysis focuses on the longer-term effect of the feedback intervention. • The feedback intervention is inexpensive and could be continued systemwide.
وصف الملف: application/pdf
اللغة: English
تدمد: 2451-8654
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a4f32e9d651dcfa93d4f09ce51741978
http://www.sciencedirect.com/science/article/pii/S2451865421000144
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....a4f32e9d651dcfa93d4f09ce51741978
قاعدة البيانات: OpenAIRE
الوصف
تدمد:24518654