Long Term Effect of General Practitioner Education on Antibiotic Prescribing

Respiratory Tract Infections Clinical Trial

— PAAIR2  

Official title:

Long Term Effect of General Practitioner Education on Antibiotic Prescribing: a Large Scale Randomized Study

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT01107223
• Other study ID #: PAAIR2
• Status: Active, not recruiting
• Phase: N/A
• First received: March 4, 2010
• Last updated: April 19, 2010
• Start date: September 2004
• Est. completion date: April 2010

Study information

• Verified date: February 2010
• Source: Henri Mondor University Hospital
• Contact: n/a
• Is FDA regulated: No
• Health authority: France: Institutional Ethical Committee
• Study type: Interventional

Clinical Trial Summary

Respiratory tract infections are the most common indication for antibiotic prescribing in primary care. Several studies have shown a strong relationship between antibiotic use and bacterial resistance. The aim of this trial was to assess the long-term effect of a continuous education program on general practitioners antibiotic prescribing behaviour. 170 physicians were included in this study. Physicians randomized in the education group attended a two days seminar focused on evidence-based guidelines on antibiotic use in respiratory tract infections. The intervention was limited at physicians level and did not target the patients.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 170
• Est. completion date: April 2010
• Est. primary completion date: April 2009
• Accepts healthy volunteers: No
• Gender: Both
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• General practitioners practicing in three departments of the Parisian area in France

• General practitioners attending a two days didactic educational meeting on evidence-based guidelines for diagnosis and treatment of acute respiratory tract infection.

Exclusion Criteria:

Study Design

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

Related Conditions & MeSH terms

• Respiratory Tract Infections

Intervention

Other:
• Experimental: Training to antibiotic prescription
GPs assigned to the intervention group attended a two days didactic educational meeting on evidence-based guidelines for diagnosis and treatment of acute respiratory tract infection.
• No education on antibiotic prescription rules.
GPs assigned to control group received no specific recommendations on antibiotic prescription.

Locations

Country	Name	City	State
France	Henri Mondor Hospital, department of general practice	Créteil

Sponsors (1)

Lead Sponsor	Collaborator
Henri Mondor University Hospital

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in the percentage of prescriptions containing an antibiotic between control and intervention groups (seminar on the treatment of respiratory tract infections).	All prescriptions written by all general practitioners enrolled in the study were extracted each year from the French National Health System database. All data were compared to 2004 (baseline). Education group GPs attended a two-day seminar presenting evidence-based guidelines on antibiotic prescription in respiratory tract infections. The change (compared to baseline) in the percentage of prescriptions containing an antibiotic (antibiotic prescription rates) was compared between control and intervention groups.	Effect of the intervention 4 to 6 months after the educational training.	No
Primary	Change in the cost of antibiotic prescription between control and intervention groups (seminar on the treatment of respiratory tract infections).	All prescriptions written by all general practitioners enrolled in the study were extracted each year from the French National Health System database. All data were compared to 2004 (baseline). Education group GPs attended a two-day seminar presenting evidence-based guidelines on antibiotic prescription in respiratory tract infections. The change (compared to baseline) in the cost of antibiotic prescription was compared between control and intervention groups.	Effect of the intervention 4 to 6 months after the educational training.	No
Secondary	Long term antibiotic prescription rates	Long term change in the percentage of antibiotic prescriptions between both groups	Effect of the intervention 28 to 30 months after the educational training.	No
Secondary	Long term antibiotic cost.	Long term change in the cost of antibiotic prescriptions between both groups	Effect of the intervention 28 to 30 months after the educational training.	No
Secondary	Symptomatic drug prescription rates	Prescription rates of symptomatic drug for respiratory infections between both groups	Effect of the intervention 28 to 30 months after the educational training.	No
Secondary	Symptomatic drug cost.	Cost of symptomatic drug between both groups	Effect of the intervention 28 to 30 months after the educational training.	No
Secondary	Effect of patient age.	Effect of patient age on antibiotic prescription between both groups	Effect of the intervention 28 to 30 months after the educational training.	No
Secondary	Effect of a seminar on problem-solving strategy on prescriptions.	A second randomization was performed among the intervention group. In one subgroup, GPs attended an additional seminar on problem-solving strategies. Antibiotic prescription rates were compared between controls, evidence-based and problem-solving subgroups. Antibiotic cost was also compared between the both subgroups	Effect of the intervention 28 to 30 months after the educational training.	No