DECISION+: Une Formation Pour Les médecins de Famille Sur la Prise de décision partagée Afin d'Optimiser Les décisions Cliniques Concernant l'Utilisation d'Antibiotiques Pour Les Infections aiguës Des Voies Respiratoires (IAVR)
Overview
- Phase
- Phase 1
- Intervention
- Not specified
- Conditions
- Acute Respiratory Infections
- Sponsor
- CHU de Quebec-Universite Laval
- Enrollment
- 712
- Locations
- 1
- Primary Endpoint
- Proportion of patients reporting a decision for "immediate antibiotics."
- Status
- Completed
- Last Updated
- 13 years ago
Overview
Brief Summary
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.
Investigators
France Legare
Canada Research Chair in Implementation of Shared Decision Making in Primary Care
CHU de Quebec-Universite Laval
Eligibility Criteria
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).
- •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:
- •Patients with a condition requiring emergency care will be excluded.
Outcomes
Primary Outcomes
Proportion of patients reporting a decision for "immediate antibiotics."
Time Frame: After index consultation
Secondary Outcomes
- Decision to use antibiotics(After index consultation)
- Decisional conflict(After index consultation)
- Adherence to the decision that was made(2 weeks after the index consultation)
- Decisional regret(2 weeks after the index consultation)
- Quality of life (QOL)(Baseline and 2 weeks after the index consultation)
- Intention to engage in SDM in future consultations dealing with antibiotic use for ARI(Baseline and 2 weeks after the index consultation)