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NCT05226260 Clinical Trial

Decreasing Antibiotic Duration for Skin and Soft Tissue Infection Using Behavioral Economics in Primary Care

Cellulitis Clinical Trial

— SSTIBE  

Official title:
Decreasing Antibiotic Duration for Skin and Soft Tissue Infections in Pediatric Primary Care Using Behavioral Economics Methods, A Cluster Randomized Trial

Clinical Trial Details — Status: Active, not recruiting

Administrative data
NCT number NCT05226260
Other study ID # STUDY00001964
Secondary ID
Status Active, not recruiting
Phase N/A
First received
Last updated
Start date November 1, 2021
Est. completion date March 1, 2024

Study information
Verified date September 2023
Source Nationwide Children's Hospital
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Study the efficacy of a package of behavioral economics strategies (versus an education-only control condition) in altering clinician behavior regarding antibiotic prescription duration for skin and soft tissue infection (SSTI).

Description:

The investigators propose a prospective, cluster randomized trial of Epic order panels in the 14 Nationwide Children's Hospital (NCH) primary care clinics. Investigators have designed user-friendly Epic order panels from which providers may select guideline concordant antibiotics by simply typing in a diagnosis (cellulitis) or antibiotic name. These order panels are prepopulated with the default, short-course (guideline-concordant) antibiotic duration, saving clinicians several clicks within the electronic medical record (EMR). If a provider changes the prescribed duration from the one defaulted, a free text box will appear for them to write an acknowledgement reason (accountable justification). All 14 clinics will receive baseline education (control condition) about common infections and local and national guidelines for antibiotic choice and duration of treatment. Clinician prescribers will also be instructed about the presence of a basic order panel. The full functionality of the default [short/desired] duration order panel will only be released to intervention clinics. The order panels will be restricted in Epic to clinics randomized to the intervention. The investigators hypothesize that clinics with the intervention will have higher rates of short course antibiotics for SSTI versus control clinics.

Recruitment information / eligibility
Status Active, not recruiting
Enrollment 98
Est. completion date March 1, 2024
Est. primary completion date March 1, 2024
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 3 Months to 99 Years
Eligibility Inclusion Criteria: - diagnosis codes A46 (cellulitis), L03 (cellulitis and acute lymphangitis), J34 or L02 (abscess, furuncle), or L01 (impetigo) AND - those who received a prescription for an enteral antibiotic - patient's treated in Nationwide Children's Hospital primary care clinics Exclusion Criteria: - Patients less than 3 months of age - Animal bite - Human bite - Foreign body - Diagnosis of hidradenitis suppurativa - Immunocompromising conditions (primary immune deficiency, chemotherapy, etc) - burns

Study Design

Related Conditions & MeSH terms

Intervention

Behavioral:
• Default Duration order Panel
The SSTI order panel will present itself when a provider types in either a drug name or diagnosis (cellulitis, impetigo, etc). Clinicians in control clinics will have access to a basic order panel which will include diagnosis and corresponding antibiotic of choice. Clinicians in intervention clinics will have access to order panels with the following additional components: prepopulated order duration fields that default to the recommended treatment duration.

Locations
Country Name City State
United States Nationwide Children's Hospital Primary Care Clinics Columbus Ohio

Sponsors (1)
Lead Sponsor Collaborator
Nationwide Children's Hospital

Country where clinical trial is conducted

United States, 

Outcome
Type Measure Description Time frame Safety issue
Primary Rate of short antibiotics Rates of long and short antibiotics will be analyzed on the clinic and provider level for both intervention and control groups 12 months
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