Evaluation of the Roche Liat Flu/RSV Assay for Management of Influenza in the Emergency Department

Influenza, Human Clinical Trial

— Influenza  

Official title:

Evaluation of the Roche Cobas Liat Flu/RSV Assay for Management of Influenza in the Emergency Department

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02899065
• Other study ID #: 906232
• Status: Completed
• Phase: N/A
• Start date: March 6, 2018
• Est. completion date: May 20, 2022

Study information

• Verified date: September 2023
• Source: University of California, Davis
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This will be a prospective, patient-oriented, pilot randomized clinical trial to evaluate (in aggregate) both the use of the Roche Cobas Liat Flu/RSV Assay and the use of pharmacist-led education for providers in the interpretation of these test results.

Description:

To determine if pharmacist-led education and procalcitonin testing as part of a stewardship intervention optimizes antiviral treatment and reduces antibiotic treatment for pediatric Emergency Department (ED) patients with suspected influenza v. standard care (i.e. rapid molecular influenza test without patient specific treatment recommendations) using a prospective, patient-randomized design. Consented patients in the pediatric ED will be randomized into two arms: The intervention arm will receive a patient specific stewardship intervention and procalcitonin testing during the ED visit. The intervention will be pharmacist-led and include direct delivery to clinicians of information about interpreting test results and recommendations for antiviral-treatment for high-risk patients, and infection control precautions for patients being hospitalized with a positive RSV or influenza test. Clinician adherence to treatment guidelines with and without the educational intervention will be compared. The second arm will be usual care (i.e. no procalcitonin test or pharmacist-led education). Results will be delivered via standard of care through the electronic medical record (EMR). Physicians and patients will not be blinded to arm assignments. Tests will be performed on a real-time basis in the ED. For each of these groups, data of the frequency and duration of antibiotic administration, antiviral use, adherence to evidence based guidelines for treatment of influenza, isolation, hospitalizations, and unscheduled return visits or readmissions within a 30 day period will be collected and compared. Research coordinators will contact patients and/or parents at 1 and 4 weeks after enrollment for self-reported secondary outcomes including symptom resolution, return to school/work, and follow up healthcare visits, medication adherence (to antibiotics and/or antivirals), and adverse events.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 200
• Est. completion date: May 20, 2022
• Est. primary completion date: April 15, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A to 49 Years

Eligibility

Inclusion Criteria:

• Patients <50 years of age who are evaluated in the emergency department for:
• suspected influenza, including symptoms of influenza-like illness (ILI - including fever > 38 degrees Celsius and cough or sore throat), or
• non-specific upper respiratory infection (URI) for whom the clinician suspects the presence of RSV, or influenza, or lower respiratory infection LRI).
• Patients whose treating provider has ordered a Roche Cobas Liat Flu/RSV test.

Exclusion Criteria:

• Patients who are pregnant
• Prisoners
• Patients who are unable to give informed consent in English or Spanish.
• Provider is unwilling to wait for procalcitonin results.

Related Conditions & MeSH terms

• Emergencies
• Influenza, Human

Intervention

Diagnostic Test:
• Procalcitonin
Procalcitonin is a blood test used to differentiate between viral and bacterial infections. This test is expected to aid in determining the best course of treatment for patients enrolled into this arm.

Other:
• Pharmacist-Led Education
Pharmacists will interpret the results of the Roche Cobas Liat Flu/RSV assay and procalcitonin test (if available) and provide the treating physician with recommendations for antibiotic therapy based on these results.

Locations

Country	Name	City	State
United States	University of California, Davis Medical Center	Sacramento	California

Sponsors (2)

Lead Sponsor	Collaborator
University of California, Davis	Roche Pharma AG

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of Participants Prescribed Antibiotics	The determination of whether use of the Roche Cobas/Liat Flu/RSV Assay as part of a stewardship intervention reduces antibiotic treatment for pediatric ED patients with suspected influenza. Proper adherence to treatment guidelines after results should reduce physician prescription of antibiotic for non-responsive conditions.	During ED stay, up to 48 hours
Primary	Number of Participants Prescribed Antiviral Therapy	The determination of whether use of the Roche Cobas Liat Flu/RSV Assay as part of a formal stewardship intervention optimizes antiviral treatment of pediatric ED patients with influenza at risk of complications.	During ED stay, up to 48 hours
Secondary	Emergency Department Recidivism	Emergency Department return visits within 30 days for patients diagnosed with influenza and RSV	30 days
Secondary	Symptom Resolution	Time to resolution of symptoms such as fever, cough or sore throat	7 days and again at week 4
Secondary	Lost Days of School/Work	Number of days of school and/or work missed due to illness	7 days and again at week 4

External Links

•   Learn more or sign up for the study here!