Changing the Antibiotic Prescribing of General Practice Registrars through better adherence to antibiotic guidelines

• Register: ANZCTR
• Last refreshed on: 13 January 2020
• Main ID: ACTRN12614001209684
• Date of registration: 17/11/2014
• Prospective Registration: No
• Primary sponsor: Professor Mieke van Driel
• Public title: Changing the Antibiotic Prescribing of General Practice Registrars through better adherence to antibiotic guidelines
• Scientific title: The effect of an educational intervention on general practice vocational trainees compared to the usual educational program on prescribing antibiotics in upper respiratory tract infections and acute bronchitis/bronchiolitis
• Date of first enrolment: 01/02/2009
• Target sample size: 290
• Recruitment status: Active, not recruiting
• URL: https://anzctr.org.au/ACTRN12614001209684.aspx
• Study type: Interventional
• Study design: Purpose: Educational / counselling / training; Allocation: Non-randomised trial; Masking: Open (masking not used);Assignment: Parallel;Type of endpoint: Efficacy;
• Phase: Not Applicable

Countries of recruitment

Australia

Contacts

• Name: Prof Mieke L van Driel

• Name: Prof Mieke L van Driel

Key inclusion & exclusion criteria

Inclusion criteria: Intervention group: Registrars in Terms 1 and 2 of their vocational training program at two RTPs (General Practice Training Valley to Coast – GPTVTC – and Adelaide to Outback General Practice Training – AOGP) who provide consent for the data they collect as part of the ReCEnT project to be used for research purposes.
Control group: Registrars in Terms 1 and 2 of their vocational training program at three RTPs (General Practice Tasmania – GPTT – and Victorian Metropolitan Alliance – VMA – and Tropical Medicine Training –TMT) who provide consent for the data they collect as part of the ReCEnT project to be used for research purposes.

Exclusion criteria: Intervention group: Registrars in Terms 1 and 2 of their vocational training program at two RTPs (General Practice Training Valley to Coast – GPTVTC – and Adelaide to Outback General Practice Training – AOGP) who do not provide consent for the data they collect as part of the ReCEnT project to be used for research purposes.
Control group: Registrars in Terms 1 and 2 of their vocational training program at three RTPs (General Practice Tasmania – GPTT – and Victorian Metropolitan Alliance – VMA – and Tropical Medicine Training –TMT) who do not provide consent for the data they collect as part of the ReCEnT project to be used for research purposes.

Age minimum: No limit
Age maximum: No limit
Gender: Both males and females

Health Condition(s) or Problem(s) studied

Public Health - Health service research

Antibiotic prescribing for upper respiratory tract infections (URTI) ;Antibiotic prescribing for acute bronchitis/bronchiolitis;
Antibiotic prescribing for upper respiratory tract infections (URTI)

Antibiotic prescribing for acute bronchitis/bronchiolitis

Respiratory - Other respiratory disorders / diseases

Intervention(s)

The intervention in the ChAP study consists of three components: 1) access to two online learning modules, 2) a face-to-face interactive workshop, and 3) engagement of the registrar's supervisor.
1. The first component is a predisposing activity consisting of access to two of the three INternet TRaining for AntibiOtic use (INTRO) electronic modules (developed within the European Union funded GRACE study) adapted for the Australian context. The first module contains information about the epidemiology of respiratory infections in primary care, antibiotic use in Australia and worldwide, information about antimicrobial resistance, and evidence supporting the recommendations from clinical guidelines, with a special focus on the electronic Therapeutics Guidelines: Australia (Antibiotics) 2013 version (eTG:A). This module will take 10-30 minutes to complete depending on the level of perusal of the materials provided in the module.
INTRO module 2 will not be used as it concerns CRP-testing which is currently not recommended in the Australian Therapeutic Guidelines.
INTRO module 3 focuses on communication skills training through videos showing how a GP can use communication skills to elicit patient concerns and expectations, discuss the pros and cons of antibiotic treatment and the natural course of respiratory infections. The communication training takes 25-30 minutes to complete and is supported by a patient booklet that can be used in the consultation.
The online modules will be made available to registrars to work through individually at a time prior to the face-to-face session. They will be given a time frame of 2 weeks in which to complete the modules. The face-to-face session will occur after completion of the electronic modules in order to maximise the po

Primary Outcome(s)

The proportion of consultations for URTI (International Classification of Primary Care version 2 PLUS chapter R74) in which antibiotics are prescribed. Antibiotic prescription derived from ReCEnT study recording of registrars’ prescribing.
[Pre-intervention and at 4 months post-intervention
]

Secondary Outcome(s)

Proportion of consultations for sore throat (International Classification of Primary Care version 2 PLUS chapter R76) in which antibiotics are prescribed. Antibiotic prescription derived from ReCEnT study recording of registrars’ prescribing. [Pre-intervention and at 4 months post-intervention ]

Proportion of consultations for acute otitis media (International Classification of Primary Care version 2 PLUS chapter H71) in which antibiotics are prescribed. Antibiotic prescription derived from ReCEnT study recording of registrars’ prescribing.[Pre-intervention and at 4 months post-intervention ]

Proportion of consultations for URTI and bronchitis/bronchiolitis (International Classification of Primary Care version 2 PLUS chapters R74 and R78) in which antibiotics are prescribed. Antibiotic prescription derived from ReCEnT study recording of registrars’ prescribing. [Pre-intervention and at 4 months post-intervention ]

Proportion of consultations for acute sinusitis (International Classification of Primary Care version 2 PLUS chapter R75) in which antibiotics are prescribed. Antibiotic prescription derived from ReCEnT study recording of registrars’ prescribing.[Pre-intervention and at 4 months post-intervention ]

Secondary ID(s)

Nil

Source(s) of Monetary Support

The Royal Australian College of General Practitioners

Secondary Sponsor(s)

Dr Simon Morgan

Associate Professor Patrick McElduff

Dr Lawrie McArthur

Conjoint Professor Parker Magin

Dr Anthea Dallas

Ethics review

Status: Approved
Approval date:
Contact:

Human Research Ethics Committee (HREC), University of Newcastle

Status: Approved
Approval date:
Contact:

Medical Research Ethics Committee, University of Queensland