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Supporting the improvement and management of prescribing for urinary tract infections (SIMPle): protocol for a cluster randomized trial.
Duane, Sinead Callan, Aoife Galvin, Sandra Murphy, Andrew W Domegan, Christine O'Shea, Eamon Cormican, Martin Bennett, Kathleen O'Donnell, Martin Vellinga, Akke
Duane, Sinead
Callan, Aoife
Galvin, Sandra
Murphy, Andrew W
Domegan, Christine
O'Shea, Eamon
Cormican, Martin
Bennett, Kathleen
O'Donnell, Martin
Vellinga, Akke
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Editors
Other Contributors
Date
2013
Date Submitted
Keywords
PRIMARY CARE
PRESCRIBING
GENERAL PRACTITIONERS
ANTIBIOTIC USE
PRESCRIBING
GENERAL PRACTITIONERS
ANTIBIOTIC USE
Other Subjects
Subject Mesh
Planned Date
Start Date
Collaborators
Principal Investigators
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1745621514441.pdf
Adobe PDF, 561.33 KB
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Abstract
The overuse of antimicrobials is recognized as the main selective pressure driving the emergence and spread of antimicrobial resistance in human bacterial pathogens. Urinary tract infections (UTIs) are among the most common infections presented in primary care and empirical antimicrobial treatment is currently recommended. Previous research has identified that a substantial proportion of Irish general practitioners (GPs) prescribe antimicrobials for UTIs that are not in accordance with the Guidelines for Antimicrobial Prescribing in Primary Care in Ireland. The aim of this trial is to design, implement and evaluate the effectiveness of a complex intervention on GP antimicrobial prescribing and adult (18 years of age and over) patients' antimicrobial consumption when presenting with a suspected UTI.
The Supporting the Improvement and Management of Prescribing for urinary tract infections (SIMPle) study is a three-armed intervention with practice-level randomization. Adult patients presenting with suspected UTIs in primary care will be included in the study.The intervention integrates components for both GPs and patients. For GPs the intervention includes interactive workshops, audit and feedback reports and automated electronic prompts summarizing recommended first-line antimicrobial treatment and, for one intervention arm, a recommendation to consider delayed antimicrobial treatment. For patients, multimedia applications and information leaflets are included. Thirty practices will be recruited to the study; laboratory data indicate that 2,038 patients will be prescribed an antimicrobial in the study. The primary outcome is a change in prescribing of first-line antimicrobials for UTIs in accordance with the Guidelines for Antimicrobial Prescribing in Primary Care in Ireland. The study will take place over 15 months with a six-month intervention period. Data will be collected through a remote electronic anonymized data-extraction system, a text-messaging system and GP and patient interviews and surveys. The intervention will be strengthened by the implementation of a social marketing framework and an economic evaluation.
This intervention is registered at ClinicalTrials.gov, ID NCT01913860.
The Supporting the Improvement and Management of Prescribing for urinary tract infections (SIMPle) study is a three-armed intervention with practice-level randomization. Adult patients presenting with suspected UTIs in primary care will be included in the study.The intervention integrates components for both GPs and patients. For GPs the intervention includes interactive workshops, audit and feedback reports and automated electronic prompts summarizing recommended first-line antimicrobial treatment and, for one intervention arm, a recommendation to consider delayed antimicrobial treatment. For patients, multimedia applications and information leaflets are included. Thirty practices will be recruited to the study; laboratory data indicate that 2,038 patients will be prescribed an antimicrobial in the study. The primary outcome is a change in prescribing of first-line antimicrobials for UTIs in accordance with the Guidelines for Antimicrobial Prescribing in Primary Care in Ireland. The study will take place over 15 months with a six-month intervention period. Data will be collected through a remote electronic anonymized data-extraction system, a text-messaging system and GP and patient interviews and surveys. The intervention will be strengthened by the implementation of a social marketing framework and an economic evaluation.
This intervention is registered at ClinicalTrials.gov, ID NCT01913860.
Language
en
ISSN
1745-6215
eISSN
ISBN
DOI
10.1186/1745-6215-14-441
PMID
24359543