Antibiotic Prescribing by GPs for URTI. Clinical Trial
Official title:
Developing and Evaluating Interventions to Reduce Inappropriate Prescribing by General Practitioners of Antibiotics for Upper Respiratory Tract Infections: an RCT to Compare Paper-based and Web-based Modelling Experiments
1. Do paper-based and web-based intervention modelling experiments (the methodology we are
developing) identify the same predictors of GP behaviour regarding prescribing of
antibiotics for upper respiratory tract infections?
2. Can a web-based IME system provide trialists with richer and more predictive
information upon which to base the development of behavioural change interventions than
paper-based IME systems?
The NHS needs effective quality improvement interventions to be put into clinical practice,
which requires effective behaviour change interventions. Intervention modelling experiments
(IMEs) are a way of exploring and refining an intervention before moving to a full-scale
trial. They do this by delivering key elements of the intervention in a simulation that
approximates clinical practice by, for example, presenting GPs with a clinical scenario
about making a treatment decision. Earlier IMEs have been paper-based, which limits what can
be done in the simulation.
Web-based IMEs provide the potential for better clinical simulations, which have the
potential to lead to better interventions. The current proposal will run a full, web-based
IME involving 250 GPs that will advance the methodology of IMEs by directly comparing
results with an earlier paper-based IME. Moreover, the web-based IME will evaluate an
intervention that can be put into a full-scale trial that aims to reduce antibiotic
prescribing in primary care. Reducing inappropriate prescribing of antibiotics in general
practice is a national priority; indeed, antibiotic use is increasing in the UK and
Scotland's prescribing is second highest amongst UK administrations. More effective
behaviour change interventions are needed and this proposal will develop one such
intervention and a system to model and test future interventions. This system will be
applicable to any situation in the NHS where behaviour needs to be modified, including
interventions aimed directly at the public.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Health Services Research