Demonstration of Near Zero Antibiotic Prescribing for Acute Bronchitis
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 400
- 试验地点
- 1
- 主要终点
- Antibiotic prescribing rate
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 64 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •first visit in 30 days, age 18-64, has a cough of less than 3 weeks duration
排除标准
- •infiltrate on chest x-ray, has chronic lung disease
研究组 & 干预措施
Intervention Arm
Single arm in the study of doctors receiving feedback about their antibiotic prescribing rate for acute bronchitis.
干预措施: Demonstration of near zero antibiotic prescribing for patients with acute bronchitis (Behavioral)
结局指标
主要结局
Antibiotic prescribing rate
时间窗: 30 days
The antibiotic prescribing rate for patients with acute bronchitis
次要结局
- 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)
研究者
Jeffrey A. Linder
Associate Physician
Brigham and Women's Hospital