Demonstration of Near Zero Antibiotic Prescribing for Acute Bronchitis

Cough Clinical Trial

Official title:

Demonstration of Near Zero Antibiotic Prescribing for Acute Bronchitis

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01240174
• Other study ID #: 2010P001247
• Status: Completed
• Phase: N/A
• First received: November 10, 2010
• Last updated: January 30, 2017
• Start date: March 2011
• Est. completion date: July 2014

Study information

• Verified date: January 2017
• Source: Brigham and Women's Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Studies show, guidelines state, and performance measures assert that antibiotic prescribing for uncomplicated acute bronchitis is inappropriate. However, clinicians prescribe antimicrobials in over 60% of the 22.5 million acute bronchitis visits in the United States each year. Previous successful interventions have only reduced the antimicrobial prescribing rate to 40% or 50%. It is unknown if the antimicrobial prescribing rate for acute bronchitis can be brought to near zero percent in actual practice while maintaining patient safety and satisfaction. The goal of this study is to develop an Electronic Health Record (EHR)-integrated algorithm for the diagnosis and treatment of adults with acute bronchitis with a goal of reducing the antibiotic prescribing rate to near zero percent.

Description:

We will use a multi-modal implementation - including computerized decision support, reporting tools, and clinician feedback - and quality improvement techniques to ensure adherence to the algorithm and reduce the antimicrobial prescribing rate to near zero percent. The duration of the intervention will be 4 years.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 400
• Est. completion date: July 2014
• Est. primary completion date: June 2014
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 64 Years

Eligibility

Inclusion Criteria:

• first visit in 30 days, age 18-64, has a cough of less than 3 weeks duration

Exclusion Criteria:

• infiltrate on chest x-ray, has chronic lung disease

Related Conditions & MeSH terms

• Acute Disease
• Bronchitis
• Cough

Intervention

Behavioral:
• Demonstration of near zero antibiotic prescribing for patients with acute bronchitis
A controlled, continuously-monitored, implementation of an EHR-integrated diagnosis and treatment algorithm for acute bronchitis in a large, diverse primary care practice.

Locations

Country	Name	City	State
United States	Brigham and Women's Hospital Jen Center for Primary Care	Boston	Massachusetts

Sponsors (2)

Lead Sponsor	Collaborator
Brigham and Women's Hospital	Agency for Healthcare Research and Quality (AHRQ)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Antibiotic prescribing rate	The antibiotic prescribing rate for patients with acute bronchitis	30 days
Secondary	Patient symptoms		21 days
Secondary	Patient satisfaction		21 days
Secondary	Patient safety		30 days
Secondary	Healthcare costs		30 days
Secondary	The capture and description of the components that had the greatest effect on the antimicrobial prescribing rate		3 years