Otitis Media Clinical Trial
— BIOSOfficial title:
Broad Implementation of Outpatient Stewardship (BIOS) Project
Verified date | January 2024 |
Source | Children's Hospital of Philadelphia |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Reducing inappropriate antibiotic use is a key strategy to mitigate antibiotic resistance and adverse health effects associated with antibiotic exposure. The Broad Implementation of Outpatient Stewardship (BIOS) project focuses on broadly implementing an evidence-based intervention to improve antibiotic prescribing for acute respiratory tract infections in pediatric outpatient settings. Primary aims include: (1) examining the acceptability, feasibility and utility of a focused implementation strategy on improving intervention adoption and impact and (2) measuring the effectiveness of the intervention to reduce unnecessary broad-spectrum antibiotic prescription.
Status | Active, not recruiting |
Enrollment | 1032 |
Est. completion date | April 21, 2025 |
Est. primary completion date | April 21, 2025 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 6 Months to 12 Years |
Eligibility | Inclusion Criteria: - Clinician inclusion criteria: Any non-trainee clinician who prescribes and provides care for children aged 6 months to 12 years with ARTIs and who is practicing at an included site. Clinicians will further be selected based on employment status at time of randomization and volume of prescribing over the past 12 months. - Visit inclusion criteria: visits made by patients of all participating practices aged 6 months through 12 years of age will be considered part of the project population. Exclusion Criteria: - Clinician exclusion criteria: clinicians who are trainees, who do not prescribe (or prescribe very infrequently) to the patient population of interest, or who do not provide care for (or provide care very infrequently for) children aged 6 months to 12 years with ARTIs will be excluded - Visit exclusion criteria: visit by children with complex chronic conditions, as well as those treated with an antibiotic in the past 30 days, will have their data extracted but will be excluded from analyses |
Country | Name | City | State |
---|---|---|---|
United States | MetroHealth | Cleveland | Ohio |
United States | Nationwide Children's Hospital | Cleveland | Ohio |
United States | Penn State Health | Hershey | Pennsylvania |
United States | Children's Hospital of Philadelphia | Philadelphia | Pennsylvania |
United States | Pediatric Associates | Plantation | Florida |
Lead Sponsor | Collaborator |
---|---|
Children's Hospital of Philadelphia | American Academy of Pediatrics, Nationwide Children's Hospital, Patient-Centered Outcomes Research Institute, Pediatric Associates of Florida, Penn State Health, The MetroHealth System, University of Pennsylvania |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Rate of broad-spectrum (off-guideline) antibiotic prescribing for all bacterial ARTIs | The proportion of visits for bacterial ARTIs during which a broad-spectrum antibiotic was prescribed. Assessed using electronic health record data. | from baseline (up to 36 months prior to randomization) through each of the study periods (up to 27 months of intervention time following intervention initiation) | |
Primary | Rate of antibiotic prescribing for all ARTIs (viral and bacterial) | The proportion of visits for all ARTIs (viral and bacterial) during which an antibiotic was prescribed | from baseline (up to 36 months prior to randomization) through each of the study periods (up to 27 months of intervention time following intervention initiation) | |
Primary | Engagement with intervention | Investigators will measure clinicians' completion rates of the educational modules and view rates of the feedback reports. Assessed through clinician attestation. | Period 1 through period 3 (up to 27 months of intervention time following intervention initiation) | |
Primary | Implementation of the intervention | Investigators will use surveys and qualitative interviews to measure the extent to which the intervention was implemented as designed. | Surveys administered at the start of or just prior to period 1, during period 2, and during period 3. Interviews conducted during period 2. | |
Secondary | Rate of broad-spectrum (off-guideline) antibiotic prescribing by practice setting | The proportion of visits for bacterial ARTIs during which a broad-spectrum antibiotic was prescribed by practice setting (Emergency department, urgent care, pediatric primary care, family medicine/medicine-pediatrics). Assessed using electronic health record data. | from baseline (up to 36 months prior to randomization) through each of the study periods (up to 27 months of intervention time following intervention initiation) | |
Secondary | Rate of broad-spectrum (off-guideline) antibiotic prescribing by ARTI type | The proportion of visits for bacterial ARTIs during which a broad-spectrum antibiotic was prescribed by ARTI type. Assessed using electronic health record data. | from baseline (up to 36 months prior to randomization) through each of the study periods (up to 27 months of intervention time following intervention initiation) | |
Secondary | Rate of broad-spectrum (off-guideline) antibiotic prescribing by intervention participation status | The proportion of visits for bacterial ARTIs during which a broad-spectrum antibiotic was prescribed by whether clinicians attested to completing study activities. Assessed using electronic health record data. | from baseline (up to 36 months prior to randomization) through each of the study periods (up to 27 months of intervention time following intervention initiation) | |
Secondary | Rate of broad-spectrum (off-guideline) antibiotic prescribing by geographic location within each practice setting | The proportion of visits for bacterial ARTIs during which a broad-spectrum antibiotic was prescribed by geographic location within each practice setting (Emergency department, urgent care, pediatric primary care, family medicine/medicine-pediatrics). Assessed using electronic health record data. | from baseline (up to 36 months prior to randomization) through each of the study periods (up to 27 months of intervention time following intervention initiation) | |
Secondary | Rate of antibiotic prescribing for all ARTIs (viral and bacterial) by practice setting | The proportion of visits for all ARTIs (viral and bacterial) during which an antibiotic was prescribed by practice setting (Emergency department, urgent care, pediatric primary care, family medicine/medicine-pediatrics). Assessed using electronic health record data. | from baseline (up to 36 months prior to randomization) through each of the study periods (up to 27 months of intervention time following intervention initiation) | |
Secondary | Rate of antibiotic prescribing for all ARTIs (viral and bacterial) by intervention participation status | The proportion of visits for all ARTIs (viral and bacterial) during which an antibiotic was prescribed by whether clinicians attested to completing study activities. Assessed using electronic health record data. | from baseline (up to 36 months prior to randomization) through each of the study periods (up to 27 months of intervention time following intervention initiation) | |
Secondary | Rate of antibiotic prescribing for all ARTIs (viral and bacterial) by geographic location within each practice setting | The proportion of visits for all ARTIs (viral and bacterial) during which an antibiotic was prescribed by geographic location within each practice setting (Emergency department, urgent care, pediatric primary care, family medicine/medicine-pediatrics). Assessed using electronic health record data. | from baseline (up to 36 months prior to randomization) through each of the study periods (up to 27 months of intervention time following intervention initiation) |
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