Clinical Trials Logo

Clinical Trial Summary

The excessive use of outpatient antibiotics in the pediatric population has contributed to the rapid development of resistance in many strains of Streptococcus pneumoniae. Research has shown that community-based interventions may have a modest impact on reducing the injudicious use of antibiotics in children. However, since the actual prescribing of antibiotics is done by physicians and research has shown that physician-parent communication patterns during pediatric visits for acute respiratory tract infections (ARTI) strongly influence antibiotic prescription rate, it is crucial to develop effective interventions aimed specifically at them.

The overall goal of this study is to improve physician-parent communication patterns during visits for pediatric ARTI and, ultimately, to decrease rates of antibiotic prescribing for these illnesses in children.


Clinical Trial Description

The overall goal of this study is to test a novel communication-based intervention aimed at decreasing rates of prescribing antibiotics for ARTI in children. We propose a randomized controlled trial involving a sample of 34 primary care pediatricians drawn from 8 practices in the Puget Sound Pediatric Research Network (PSPRN). Our research design incorporates a novel physician intervention that teaches the importance of specific physician communication behaviors. The primary physician outcomes for the study will be changes in the utilization of communication behaviors as reported by parents, and antibiotic prescribing rates for children presenting with ARTI symptoms. The primary parent outcome measure for the study will be satisfaction with care. Changes in the primary outcomes for the intervention physicians will be compared to changes in these outcomes for control physicians. The trial has five specific aims and five major hypotheses.

1. To evaluate the effectiveness of the proposed intervention in achieving its stated goals of changing physician communication behaviors.

- We hypothesize that physicians in the intervention group will have increased reported use of desirable communication behaviors and decreased reported use of undesirable communication behaviors relative to control group physicians.

2. To determine the antibiotic prescribing rates for children aged 6 months to 10 years presenting with ARTI symptoms and assess how these rates change as a function of the intervention.

- We hypothesize that physicians in the intervention group will decrease antibiotic prescribing rates for ARTI relative to the control group physicians.

3. To determine visit-specific satisfaction levels for parents of children seen by study physicians and assess how satisfaction levels change as a function of the intervention.

- We hypothesize that parents who take their children to physicians in the intervention group will report increased satisfaction with care, relative to control group physicians.

4. To identify the factors (e.g., physician communication behaviors) that mediate the relationships between physicians being in the intervention group, decreased antibiotic prescribing, and increased parent satisfaction with care.

- We hypothesize that increased use of desirable communication behaviors and decreased use of undesirable communication behaviors will partially mediate the relationships between being an intervention group physician, decreased inappropriate prescribing, and increased parent satisfaction with care.

5. To perform a validation study of the Physician Communication Behavior Inventory (PCBI) survey items. Using a standardized approach, specific physician communication behaviors will be coded through review of 100 video taped physician-parent encounters. The behaviors coded will be compared to parent responses on the PCBI surveys from these encounters.

- We hypothesize that parent reports of physician communication behaviors on the PCBI will be highly correlated with actual physician communication behaviors coded from video tape data. ;


Study Design

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research


Related Conditions & MeSH terms


NCT number NCT01168778
Study type Interventional
Source University of Washington
Contact
Status Completed
Phase N/A
Start date September 2007
Completion date April 2009

See also
  Status Clinical Trial Phase
Completed NCT03711292 - Using Behavioral Science to Reduce Inappropriate Antibiotic Use in Acute Care Settings N/A
Terminated NCT00187785 - Doctor-Patient Communication in Spanish N/A
Completed NCT00405509 - The Natural History of Viral Upper Respiratory Infections in Children Aged 6 to Less Than 14 Years N/A
Completed NCT00189475 - Evaluate the Potential of Montelukast to Prevent Nasal Symptomatology During Colds Phase 4
Completed NCT04468204 - Use of Novel Sinusonic Device for Prevention of Community Acquired Upper Respiratory Infection (URI) N/A
Active, not recruiting NCT05666752 - Effect of Intake of Allium Cepa L. Peel Heated Water Extract on Immunity Enhancement N/A
Completed NCT00255307 - Pilot Evaluation of CVT-E002 in Pediatric Upper Respiratory Tract Infection. Phase 2
Suspended NCT05035420 - A Noninvasive Multimodal Biosensing Device for Screening and Monitoring Response to Treatment of Infectious Respiratory Diseases N/A
Recruiting NCT06244615 - Clinical Trial of a Mouth and Throat Rinse for the Treatment of Acute Sore Throat N/A
Completed NCT02694679 - Randomized Controlled Trial of Social Network Targeting in Honduras N/A
Completed NCT05352581 - BD Veritorâ„¢ At-Home and BD Veritorâ„¢ Professional
Active, not recruiting NCT02943551 - Dialogue Around Respiratory Illness Treatment N/A
Completed NCT01657643 - Effect of Probiotics on Health-related Quality of Life in College Students With Upper Respiratory Infections N/A
Completed NCT02110732 - Lactobacillus Rhamnosus GG in the Middle Ear and Adenoid Tonsil N/A
Completed NCT00694421 - Gas Supply, Demand and Middle Ear Gas Balance: Specific Aim 2 N/A
Completed NCT03884777 - Incidence and Risk of Influenza in Myasthenic Patients
Completed NCT00796315 - Study Evaluating the Pharmacokinetics of Doxylamine Succinate in Children Phase 1
Completed NCT00642681 - Effects of URI on Diabetic Subjects Utilizing Technosphere Insulin After a Meal Challenge Phase 2
Completed NCT00259831 - Efficacy of Cold-FX (CVT-E002) in the Prevention of Upper Respiratory Tract Infections in Healthy Adults Phase 3
Completed NCT04588376 - Improving Antibiotic Prescribing for Pediatric Respiratory Infections by Family Physicians With Peer Comparison N/A