Digital Online Consultations - Effects on Antibiotic Prescribing and Health Care Utilization in Primary Care
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- Region Skane
- 入组人数
- 4,057
- 试验地点
- 1
- 主要终点
- Antibiotics Prescription After Sore Throat
研究概览
简要总结
BACKGROUND/SIGNIFICANCE: With developments in mobile health and the abundance of smartphones, online consultations have emerged as a popular form of primary care in Sweden. Controversy exists regarding diagnostic accuracy, appropriate prescription of antibiotics, and effects on care-seeking patient behavior following implementation of online consultations. As empirical research is lacking, the investigators seek to evaluate online primary care consultations compared to physical consultations with regards to non-inferiority of antibiotic prescription for chief complaint of sore throat.
METHODS: Medical record data is used to identify patients with a chief complaint of sore throat, cough/common cold/influenza, or dysuria after choosing online (DIGI) or physical (PHYSI) consultations. A cohort of patients with similar chief complaints prior to implementation of online consultations was used as a control group (CONTROL). Prospective data from local registries and medical records was gathered 14 days the consultation. The primary outcome was rate of antibiotic prescription after sore throat. Secondary outcomes included patient revisits (including hospital admissions), patient satisfaction, time to physician contact, registered diagnosis, and documentation or Centor Criteria and Urinary Tract Infection (UTI)-Criteria.
SIGNIFICANCE: Results will shed light on whether antibiotic prescription differs significantly between digital and physical primary care consultations. Hypotheses may also be generated as to how patients seek care in light of improved availability in a tax-sponsored healthcare system.
详细描述
Due to limited recruitment of PHYSI and CONTROL patients, these cohorts will be combined into a single physical cohort to provide adequate power for analysis as per predefined required sample size.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patient seeking care at primary healthcare provider (Capio in Skåne or Capio Go)
- •Patient who according to medical record presents with sore throat, cough/common cold/influenza, or dysuria
排除标准
- •Patient who according to medical record presents with main symptom other than sore throat, cough/common cold/influenza, or dysuria.
- •Patient under the age of 18.
结局指标
主要结局
Antibiotics Prescription After Sore Throat
时间窗: 24 hours
Proportion of patients prescribed an antibiotics (as documented in medical records) in conjunction with their initial visit with chief complaint sore throat.
次要结局
- Patient Satisfaction(24 hours)
- Antibiotics Prescription After Cough/Common Cold/Influenza(24 hours)
- UTI Criteria Documentation(24 hours)
- Antibiotics Prescription After Dysuria(24 hours)
- Patient Revisits(14 days)
- Ordering of labs for sore throat(24 hours)
- Type of Antibiotic Prescribed(24 hours)
- Registered Diagnosis(24 hours)
- Centor Criteria Documentation(24 hours)
- Time to Physician Contact(14 days)
- Ordering of labs for dysuria(24 hours)