Routine Prescription Feedback and Peer Comparison to Lower Antibiotic Prescriptions in Primary Care - a Pragmatic Randomised Controlled Trial View Homepage


Ontology type: schema:MedicalStudy     


Clinical Trial Info

YEARS

2013-2015

ABSTRACT

To evaluate the effect of a continuous postal and web-based feedback and peer comparison system of individual antibiotic prescription rates on the prescription behaviour of primary care physicians in Switzerland. Detailed Description Background: Excessive use of antibiotics may lead to unnecessary adverse events and raise the emergence of bacterial resistance, an increasingly serious problem in Europe. In absolute terms most antibiotics are prescribed in primary care with considerable unexplained variation of antibiotic use indicating the need for further important improvement of prescription practice in Switzerland. Aim: To evaluate the effect of a continuous postal and web-based feedback and peer comparison system of individual antibiotic prescription rates on the prescription behaviour of primary care physicians in Switzerland. Design: Randomized, controlled, pragmatic intervention trial. Setting: Primary care providers of Switzerland above the median of antibiotic prescription rates. Population: Primary care physicians caring for patients enlisted with social health insurance companies that provide invoice data to the SANTÉSUISSE DATENPOOL AND TARIFPOOL. Endpoints: Primary endpoint: Prescription rate of antibiotics as defined daily doses (DDD) per 100 consultations at 12 and 24 months. Secondary endpoints: Costs-savings from the intervention, acceptability of the program, percentage of prescriptions fulfilling disease-specific quality indicators for outpatient antibiotic criteria by the European Surveillance of Antimicrobial Consumption (ESAC). Intervention: Quarterly postal and electronic feedback for 24 months on the crude number of antibiotics prescribed, a population adjusted benchmark-profile in comparison to other primary care physicians, and evidence-based guidelines for the use of antibiotics in primary care. Physicians in the control group receive no information. Variables and measurement: Rates of antibiotic prescriptions overall and per drug class (DDD), cost of prescribed drugs and the intervention program; number of web-application logins and participation cancellations, and - in a sub-sample - number of prescriptions fulfilling disease-specific quality indicators for outpatient antibiotic criteria (ESAC). Expected results: We expect a 5% reduction of antibiotic prescription rates between the intervention and control groups after 12 months with an assumed participation rate (at least one web-access) and return of acceptance questionnaire of 30%. We expect that the intervention program will be cost-saving. ESAC quality indicators will be a useful tool for monitoring the quality of antibiotic prescription in ambulatory care in Switzerland. Analyses: Analysis will be done by intention to treat principles. We will use linear regression analysis to determine the difference in antibiotic prescriptions between the intervention and the control group with appropriate adjustment for the case mix of patient populations and self-dispensation. Based on outpatient data of 2009 from the Helsana insurance and conservative effect estimates a sample-size of 1427 physicians each for the intervention and control group is planned. Significance: This trial will investigate if a repeated feedback system results in a long-term reduction of antibiotic prescription practices. In addition, the feasibility of a web-based interface as communication tool to primary care physicians will be assessed. If effective, the system could be easily employed for other interventions as well. More... »

URL

https://clinicaltrials.gov/show/NCT01773824

Related SciGraph Publications

JSON-LD is the canonical representation for SciGraph data.

TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

[
  {
    "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
    "about": [
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/3177", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "type": "DefinedTerm"
      }
    ], 
    "description": "To evaluate the effect of a continuous postal and web-based feedback and peer comparison system of individual antibiotic prescription rates on the prescription behaviour of primary care physicians in Switzerland.\n\nDetailed Description\nBackground: Excessive use of antibiotics may lead to unnecessary adverse events and raise the emergence of bacterial resistance, an increasingly serious problem in Europe. In absolute terms most antibiotics are prescribed in primary care with considerable unexplained variation of antibiotic use indicating the need for further important improvement of prescription practice in Switzerland. Aim: To evaluate the effect of a continuous postal and web-based feedback and peer comparison system of individual antibiotic prescription rates on the prescription behaviour of primary care physicians in Switzerland. Design: Randomized, controlled, pragmatic intervention trial. Setting: Primary care providers of Switzerland above the median of antibiotic prescription rates. Population: Primary care physicians caring for patients enlisted with social health insurance companies that provide invoice data to the SANT\u00c9SUISSE DATENPOOL AND TARIFPOOL. Endpoints: Primary endpoint: Prescription rate of antibiotics as defined daily doses (DDD) per 100 consultations at 12 and 24 months. Secondary endpoints: Costs-savings from the intervention, acceptability of the program, percentage of prescriptions fulfilling disease-specific quality indicators for outpatient antibiotic criteria by the European Surveillance of Antimicrobial Consumption (ESAC). Intervention: Quarterly postal and electronic feedback for 24 months on the crude number of antibiotics prescribed, a population adjusted benchmark-profile in comparison to other primary care physicians, and evidence-based guidelines for the use of antibiotics in primary care. Physicians in the control group receive no information. Variables and measurement: Rates of antibiotic prescriptions overall and per drug class (DDD), cost of prescribed drugs and the intervention program; number of web-application logins and participation cancellations, and - in a sub-sample - number of prescriptions fulfilling disease-specific quality indicators for outpatient antibiotic criteria (ESAC). Expected results: We expect a 5% reduction of antibiotic prescription rates between the intervention and control groups after 12 months with an assumed participation rate (at least one web-access) and return of acceptance questionnaire of 30%. We expect that the intervention program will be cost-saving. ESAC quality indicators will be a useful tool for monitoring the quality of antibiotic prescription in ambulatory care in Switzerland. Analyses: Analysis will be done by intention to treat principles. We will use linear regression analysis to determine the difference in antibiotic prescriptions between the intervention and the control group with appropriate adjustment for the case mix of patient populations and self-dispensation. Based on outpatient data of 2009 from the Helsana insurance and conservative effect estimates a sample-size of 1427 physicians each for the intervention and control group is planned. Significance: This trial will investigate if a repeated feedback system results in a long-term reduction of antibiotic prescription practices. In addition, the feasibility of a web-based interface as communication tool to primary care physicians will be assessed. If effective, the system could be easily employed for other interventions as well.", 
    "endDate": "2015-12-01T00:00:00Z", 
    "id": "sg:clinicaltrial.NCT01773824", 
    "keywords": [
      "prescription", 
      "comparison", 
      "antibiotic prescription", 
      "Primary Health Care", 
      "randomised controlled trial", 
      "feedback", 
      "primary care physician", 
      "Switzerland", 
      "excessive use", 
      "antibiotic", 
      "adverse event", 
      "emergence", 
      "bacterial resistance", 
      "serious problem", 
      "Europe", 
      "absolute term", 
      "variation", 
      "antibiotic use", 
      "important improvement", 
      "intervention trial", 
      "setting", 
      "primary care provider", 
      "population", 
      "patient", 
      "health insurance company", 
      "endpoint", 
      "primary endpoint", 
      "daily", 
      "Referral and Consultation", 
      "secondary endpoint", 
      "saving", 
      "intervention", 
      "acceptability", 
      "specific quality", 
      "outpatient", 
      "antimicrobial", 
      "electronics", 
      "evidence-based guideline", 
      "physician", 
      "control group", 
      "variable", 
      "measurement", 
      "prescribed drug", 
      "intervention program", 
      "web application", 
      "participation", 
      "sub-sample", 
      "expected result", 
      "reduction", 
      "participation rate", 
      "web access", 
      "return", 
      "questionnaire", 
      "useful tool", 
      "Ambulatory Care", 
      "intention", 
      "principle", 
      "linear regression analysis", 
      "difference", 
      "appropriate adjustment", 
      "Diagnosis-Related Group", 
      "patient population", 
      "insurance", 
      "sample size", 
      "significance", 
      "trial", 
      "feedback system", 
      "long-term reduction", 
      "feasibility", 
      "web-based interface", 
      "communication tool"
    ], 
    "name": "Routine Prescription Feedback and Peer Comparison to Lower Antibiotic Prescriptions in Primary Care - a Pragmatic Randomised Controlled Trial", 
    "sameAs": [
      "https://app.dimensions.ai/details/clinical_trial/NCT01773824"
    ], 
    "sdDataset": "clinical_trials", 
    "sdDatePublished": "2019-03-07T15:24", 
    "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
    "sdPublisher": {
      "name": "Springer Nature - SN SciGraph project", 
      "type": "Organization"
    }, 
    "sdSource": "file:///pack/app/us_ct_data_00013.json", 
    "sponsor": [
      {
        "id": "https://www.grid.ac/institutes/grid.425888.b", 
        "type": "Organization"
      }, 
      {
        "id": "https://www.grid.ac/institutes/grid.410567.1", 
        "type": "Organization"
      }, 
      {
        "id": "https://www.grid.ac/institutes/grid.6612.3", 
        "type": "Organization"
      }
    ], 
    "startDate": "2013-10-01T00:00:00Z", 
    "subjectOf": [
      {
        "id": "https://doi.org/10.1001/jamainternmed.2016.8040", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1022867256"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/s12879-016-1739-0", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1045430417", 
          "https://doi.org/10.1186/s12879-016-1739-0"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/s12879-016-1739-0", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1045430417", 
          "https://doi.org/10.1186/s12879-016-1739-0"
        ], 
        "type": "CreativeWork"
      }
    ], 
    "type": "MedicalStudy", 
    "url": "https://clinicaltrials.gov/show/NCT01773824"
  }
]
 

Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

JSON-LD is a popular format for linked data which is fully compatible with JSON.

curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/clinicaltrial.NCT01773824'

N-Triples is a line-based linked data format ideal for batch operations.

curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/clinicaltrial.NCT01773824'

Turtle is a human-readable linked data format.

curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/clinicaltrial.NCT01773824'

RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/clinicaltrial.NCT01773824'


 

This table displays all metadata directly associated to this object as RDF triples.

101 TRIPLES      16 PREDICATES      90 URIs      80 LITERALS      1 BLANK NODES

Subject Predicate Object
1 sg:clinicaltrial.NCT01773824 schema:about anzsrc-for:3177
2 schema:description To evaluate the effect of a continuous postal and web-based feedback and peer comparison system of individual antibiotic prescription rates on the prescription behaviour of primary care physicians in Switzerland. Detailed Description Background: Excessive use of antibiotics may lead to unnecessary adverse events and raise the emergence of bacterial resistance, an increasingly serious problem in Europe. In absolute terms most antibiotics are prescribed in primary care with considerable unexplained variation of antibiotic use indicating the need for further important improvement of prescription practice in Switzerland. Aim: To evaluate the effect of a continuous postal and web-based feedback and peer comparison system of individual antibiotic prescription rates on the prescription behaviour of primary care physicians in Switzerland. Design: Randomized, controlled, pragmatic intervention trial. Setting: Primary care providers of Switzerland above the median of antibiotic prescription rates. Population: Primary care physicians caring for patients enlisted with social health insurance companies that provide invoice data to the SANTÉSUISSE DATENPOOL AND TARIFPOOL. Endpoints: Primary endpoint: Prescription rate of antibiotics as defined daily doses (DDD) per 100 consultations at 12 and 24 months. Secondary endpoints: Costs-savings from the intervention, acceptability of the program, percentage of prescriptions fulfilling disease-specific quality indicators for outpatient antibiotic criteria by the European Surveillance of Antimicrobial Consumption (ESAC). Intervention: Quarterly postal and electronic feedback for 24 months on the crude number of antibiotics prescribed, a population adjusted benchmark-profile in comparison to other primary care physicians, and evidence-based guidelines for the use of antibiotics in primary care. Physicians in the control group receive no information. Variables and measurement: Rates of antibiotic prescriptions overall and per drug class (DDD), cost of prescribed drugs and the intervention program; number of web-application logins and participation cancellations, and - in a sub-sample - number of prescriptions fulfilling disease-specific quality indicators for outpatient antibiotic criteria (ESAC). Expected results: We expect a 5% reduction of antibiotic prescription rates between the intervention and control groups after 12 months with an assumed participation rate (at least one web-access) and return of acceptance questionnaire of 30%. We expect that the intervention program will be cost-saving. ESAC quality indicators will be a useful tool for monitoring the quality of antibiotic prescription in ambulatory care in Switzerland. Analyses: Analysis will be done by intention to treat principles. We will use linear regression analysis to determine the difference in antibiotic prescriptions between the intervention and the control group with appropriate adjustment for the case mix of patient populations and self-dispensation. Based on outpatient data of 2009 from the Helsana insurance and conservative effect estimates a sample-size of 1427 physicians each for the intervention and control group is planned. Significance: This trial will investigate if a repeated feedback system results in a long-term reduction of antibiotic prescription practices. In addition, the feasibility of a web-based interface as communication tool to primary care physicians will be assessed. If effective, the system could be easily employed for other interventions as well.
3 schema:endDate 2015-12-01T00:00:00Z
4 schema:keywords Ambulatory Care
5 Diagnosis-Related Group
6 Europe
7 Primary Health Care
8 Referral and Consultation
9 Switzerland
10 absolute term
11 acceptability
12 adverse event
13 antibiotic
14 antibiotic prescription
15 antibiotic use
16 antimicrobial
17 appropriate adjustment
18 bacterial resistance
19 communication tool
20 comparison
21 control group
22 daily
23 difference
24 electronics
25 emergence
26 endpoint
27 evidence-based guideline
28 excessive use
29 expected result
30 feasibility
31 feedback
32 feedback system
33 health insurance company
34 important improvement
35 insurance
36 intention
37 intervention
38 intervention program
39 intervention trial
40 linear regression analysis
41 long-term reduction
42 measurement
43 outpatient
44 participation
45 participation rate
46 patient
47 patient population
48 physician
49 population
50 prescribed drug
51 prescription
52 primary care physician
53 primary care provider
54 primary endpoint
55 principle
56 questionnaire
57 randomised controlled trial
58 reduction
59 return
60 sample size
61 saving
62 secondary endpoint
63 serious problem
64 setting
65 significance
66 specific quality
67 sub-sample
68 trial
69 useful tool
70 variable
71 variation
72 web access
73 web application
74 web-based interface
75 schema:name Routine Prescription Feedback and Peer Comparison to Lower Antibiotic Prescriptions in Primary Care - a Pragmatic Randomised Controlled Trial
76 schema:sameAs https://app.dimensions.ai/details/clinical_trial/NCT01773824
77 schema:sdDatePublished 2019-03-07T15:24
78 schema:sdLicense https://scigraph.springernature.com/explorer/license/
79 schema:sdPublisher Nc904521badd346a29ff9941c313045b8
80 schema:sponsor https://www.grid.ac/institutes/grid.410567.1
81 https://www.grid.ac/institutes/grid.425888.b
82 https://www.grid.ac/institutes/grid.6612.3
83 schema:startDate 2013-10-01T00:00:00Z
84 schema:subjectOf sg:pub.10.1186/s12879-016-1739-0
85 https://doi.org/10.1001/jamainternmed.2016.8040
86 schema:url https://clinicaltrials.gov/show/NCT01773824
87 sgo:license sg:explorer/license/
88 sgo:sdDataset clinical_trials
89 rdf:type schema:MedicalStudy
90 Nc904521badd346a29ff9941c313045b8 schema:name Springer Nature - SN SciGraph project
91 rdf:type schema:Organization
92 anzsrc-for:3177 schema:inDefinedTermSet anzsrc-for:
93 rdf:type schema:DefinedTerm
94 sg:pub.10.1186/s12879-016-1739-0 schema:sameAs https://app.dimensions.ai/details/publication/pub.1045430417
95 https://doi.org/10.1186/s12879-016-1739-0
96 rdf:type schema:CreativeWork
97 https://doi.org/10.1001/jamainternmed.2016.8040 schema:sameAs https://app.dimensions.ai/details/publication/pub.1022867256
98 rdf:type schema:CreativeWork
99 https://www.grid.ac/institutes/grid.410567.1 schema:Organization
100 https://www.grid.ac/institutes/grid.425888.b schema:Organization
101 https://www.grid.ac/institutes/grid.6612.3 schema:Organization
 




Preview window. Press ESC to close (or click here)


...