Impact of a Multimodal Intervention on Antibiotic Prescribing for Respiratory Infections in Primary Care (GRASP)

Caen University Hospital

Status: Enrolling

Conditions: Viral Respiratory Infection (e.g., Influenza); Rhinitis / Nasopharyngitis; Acute Otitis Media (AOM); Acute Bronchitis; Serous or Congestive Otitis; Community-Acquired Pneumonia (CAP); Laryngitis; Acute Bronchiolitis; Acute Sinusitis; COPD Exacerbation (AECOPD); Angina

Treatments: Other: Antibiotic prescribing according to guidelines

Study type: Interventional

Funder types: Other

Identifiers

NCT07359287

24-0171

Details and patient eligibility

About

Antimicrobial resistance (AMR), considered one of the greatest global threats by the WHO, justifies the development of initiatives to promote appropriate antibiotic use-especially in primary care, where most antibiotics in France are prescribed and where misuse remains common.

We are proposing a cluster-randomized controlled trial to evaluate the effectiveness of a bimodal intervention combining: (1) improved communication about the circulation of respiratory viruses, and (2) strengthened collaborative practices between general practitioners and pharmacists through a multidisciplinary protocol aimed at verifying that prescribed treatment durations comply with guidelines.

The study will include six primary care practices (24 physicians), with three practices in each study arm.

The aim of this project is to assess whether the bimodal intervention can reduce the duration of antibiotic treatments for upper and lower respiratory tract infections. The first component (a "viral infection prescription" tool) focuses on reducing unnecessary treatment initiation, while the second (pharmacist-led review) aims to shorten excessive prescription durations.

Enrollment: 4,500 estimated patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

- Patient seen in consultation for an upper or lower respiratory tract infection (Angina, Acute bronchiolitis, Acute bronchitis, COPD exacerbation (AECOPD), Laryngitis, Acute otitis media (AOM), Serous or congestive otitis, Viral respiratory infection (e.g., influenza), Community-acquired pneumonia (CAP), Rhinitis / Nasopharyngitis, Acute sinusitis)

Exclusion criteria

- Patient under legal protection

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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4,500 participants in 2 patient groups

Control group

No Intervention group

Description:

The primary care practices in the control group do not receive any intervention and continue patient management according to their usual practices.

Intervention group

Experimental group

Description:

For the intervention group, two planned interventions will be planed and applied to the primary care practices: 1. Use of the OPIV (Viral Infection Prescription Tool). 2. A multidisciplinary collaboration protocol between general practitioners and pharmacists to evaluate antibiotic treatment durations. This intervention aims to strengthen collaborative practices. If a prescribed duration does not comply with recommendations, the pharmacist will discuss it with the prescriber, and the duration will be adjusted accordingly."

Treatment:

Other: Antibiotic prescribing according to guidelines