DECISION+, a Training Program to Improve Optimal Drug Prescription (Decision+)

Laval University

Status and phase

Completed

Phase 1

Conditions

Acute Respiratory Infections

Treatments

Behavioral: Decision+ program (to improve optimal drug prescription for ARI)

Study type

Interventional

Funder types

Other

Identifiers

NCT01116076

FRSQ20131

35247 (Other Identifier)

Details and patient eligibility

About

Decisions about the use of antibiotics for acute respiratory infections are the most frequently reported reason for consulting a family physician. Although it varies according to the specific type of acute respiratory infections, the use of antibiotics is estimated to be 63% to 67%, well above the expected prevalence of bacterial infections thus suggesting overuse of antibiotics. Consequently, there is an urgent need for helping family physicians and their patients to improve the clinical decision making process regarding the use of antibiotics for acute respiratory infections. We will evaluate the impact of DECISION +, a multifaceted intervention program that includes training in shared decision making, reminders and feedback targeting physicians, and decision support tools targeting patients on the decision to use antibiotics for acute respiratory infections. Results from this study will lay the ground for a national strategy targeting the improvement of the clinical decision making process regarding antibiotic use for acute respiratory infections in primary care. In turn, this will increase quality of care and patient safety.

Enrollment

712 patients

Sex

All

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

FAMILY PHYSICIANS:

Inclusion Criteria:

All FP (teachers and residents) providing care in the walk-in clinic in each Family Practice Teaching Unit (FPTU) will be eligible to participate in the trial.

Exclusion Criteria:

he/she was involved or participated in the DECISION + pilot RCT
he/she is not expected to be practicing at the FPTU for the whole duration of the study (e.g. residents ending their residency program or doing rotations outside of the FPTU, planned pregnancy/delivery, planned retirement).

PATIENTS:

Inclusion Criteria:

if 17 years old and under, must be accompanied by a parents or a guardians)
they are consulting a participating physician for an ARI, for which treatment with an antibiotic is considered
they are able (patients or the accompanying parent or guardians) to read, understand and write French (expected level: 8th grade)
they give informed consent

Exclusion Criteria: