Demonstration of Near Zero Antibiotic Prescribing for Acute Bronchitis

Not Applicable

Completed

• Conditions: Bronchitis; Cough
• Interventions: Behavioral: Demonstration of near zero antibiotic prescribing for patients with acute bronchitis

• Registration Number: NCT01240174
• Lead Sponsor: Brigham and Women's Hospital

Brief Summary

Studies show, guidelines state, and performance measures assert that antibiotic prescribing for uncomplicated acute bronchitis is inappropriate. However, clinicians prescribe antimicrobials in over 60% of the 22.5 million acute bronchitis visits in the United States each year. Previous successful interventions have only reduced the antimicrobial prescribing rate to 40% or 50%. It is unknown if the antimicrobial prescribing rate for acute bronchitis can be brought to near zero percent in actual practice while maintaining patient safety and satisfaction. The goal of this study is to develop an Electronic Health Record (EHR)-integrated algorithm for the diagnosis and treatment of adults with acute bronchitis with a goal of reducing the antibiotic prescribing rate to near zero percent.

Detailed Description

We will use a multi-modal implementation - including computerized decision support, reporting tools, and clinician feedback - and quality improvement techniques to ensure adherence to the algorithm and reduce the antimicrobial prescribing rate to near zero percent. The duration of the intervention will be 4 years.

Study Timeline

• Study First Submitted: 2010-11-10
• Study First Submitted QC: 2010-11-10
• Study First Posted: 2010-11-15
• Study Start: 2011-03
• Primary Completion: 2014-06
• Study Completion: 2014-07
• Status Verified: 2017-01
• Last Update Submitted: 2017-01-30
• Last Update Posted: 2017-02-01

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 400

Inclusion Criteria

• first visit in 30 days, age 18-64, has a cough of less than 3 weeks duration

Exclusion Criteria

• infiltrate on chest x-ray, has chronic lung disease

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Intervention Arm	Demonstration of near zero antibiotic prescribing for patients with acute bronchitis	Single arm in the study of doctors receiving feedback about their antibiotic prescribing rate for acute bronchitis.

Primary Outcome Measures

Name	Time	Method
Antibiotic prescribing rate	30 days	The antibiotic prescribing rate for patients with acute bronchitis

Secondary Outcome Measures

Name	Time	Method
Patient symptoms	21 days
Patient satisfaction	21 days
Patient safety	30 days
Healthcare costs	30 days
The capture and description of the components that had the greatest effect on the antimicrobial prescribing rate	3 years

Trial Locations

Locations (1)

Brigham and Women's Hospital Jen Center for Primary Care; 🇺🇸 Boston, Massachusetts, United States