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    Supporting the improvement and management of prescribing for urinary tract infections (SIMPle): protocol for a cluster randomized trial.

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    Authors
    Duane, Sinead
    Callan, Aoife
    Galvin, Sandra
    Murphy, Andrew W
    Domegan, Christine
    O'Shea, Eamon
    Cormican, Martin
    Bennett, Kathleen
    O'Donnell, Martin
    Vellinga, Akke
    Affiliation
    Discipline of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
    Issue Date
    2013
    Keywords
    PRIMARY CARE
    PRESCRIBING
    GENERAL PRACTITIONERS
    ANTIBIOTIC USE
    
    Metadata
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    Citation
    Supporting the improvement and management of prescribing for urinary tract infections (SIMPle): protocol for a cluster randomized trial. 2013, 14 (1):441 Trials
    Publisher
    Biomed Central
    Journal
    Trials
    URI
    http://hdl.handle.net/10147/311125
    DOI
    10.1186/1745-6215-14-441
    PubMed ID
    24359543
    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.
    Item Type
    Article
    Language
    en
    ISSN
    1745-6215
    ae974a485f413a2113503eed53cd6c53
    10.1186/1745-6215-14-441
    Scopus Count
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