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)
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 发起方
- 入组人数
- 712
- 试验地点
- 1
- 主要终点
- Proportion of patients reporting a decision for "immediate antibiotics."
研究概览
简要总结
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •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.
排除标准
- •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.
结局指标
主要结局
Proportion of patients reporting a decision for "immediate antibiotics."
时间窗: After index consultation
次要结局
- 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)
研究者
France Legare
Canada Research Chair in Implementation of Shared Decision Making in Primary Care
CHU de Quebec-Universite Laval