The Improving Rational Prescribing for Urinary Tract Infections in Frail Elderly (ImpresU) Project - Work Package 2 (WP2): a Cluster Randomised Multifaceted Antibiotic Stewardship Intervention Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 1,146
- 试验地点
- 8
- 主要终点
- UTI prescriptions
研究概览
简要总结
The purpose of this study is to determine whether a tailored multifaceted antibiotic stewardship intervention reduces antibiotic use for urinary tract infections in residential care homes and nursing homes attended by general practitioners. This will be evaluated in a pragmatic cluster randomised controlled trial using a modified community-based participatory action research approach.
详细描述
Rationale:
Almost 60% of antibiotics in frail elderly is prescribed for alleged UTI. About half of the antibiotics for UTI in this population are prescribed for non-specific signs and symptoms; a substantial part of these prescriptions might not be necessary.
Research question:
Does a tailored multifaceted antibiotic stewardship intervention reduce antibiotic use for UTI in residential care homes and nursing homes attended by general practitioners (GPs)?
Study design, setting and population:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 70 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •physical and/or mental disabilities and ADL dependency requiring residential care or nursing home care
- •attended by general practitioners
- •not on continuous prophylactic antibiotic use
排除标准
- •in hospice-care
- •very limited life expectancy (≤1 month)
- •no longer wish to participate
- •start continuous antibiotic (prophylaxis)
- •die or move away from the residential care home / nursing home
- •If patients are excluded within 2 months after inclusion, they will be taken out of the study. In other words: patients need to be included for at least 2 months to contribute data to the study.
结局指标
主要结局
UTI prescriptions
时间窗: Assessed during the 7-month follow-up period
Number of prescriptions of antibiotics for suspected urinary tract infections expressed per patient-year
次要结局
- Complications(Assessed during the 7-month follow-up period)
- Hospital referral(Assessed during the 7-month follow-up period)
- UTI suspicions(Assessed during the 7-month follow-up period)
- Mortality after UTI suspicion(Assessed during the 7-month follow-up period)
- UTI prescriptions in office hours(Assessed during the 7-month follow-up period)
- Incorrect UTI prescriptions(Assessed during the 7-month follow-up period)
- Hospital admission(Assessed during the 7-month follow-up period)
- Mortality(Assessed during the 7-month follow-up period)
研究者
Cees Hertogh
Prof. dr.
Amsterdam UMC, location VUmc