The Effectiveness of an Antimicrobial Stewardship Program (ASP) in Primary Health Care in the Management of Patients With a Sore Throat
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Tonsillitis
- Sponsor
- Vastra Gotaland Region
- Enrollment
- 49
- Locations
- 1
- Primary Endpoint
- The effect of an ASP on the change in proportion of positive RADT among patients prescribed AB - 18m
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
The investigators have developed an antibiotic stewardship program (ASP) to increase adherence to the Swedish guidelines for managing patients with a sore throat. This is a randomized controlled trial where primary health care centers are randomised to get the ASP or not. The adherence to the Swedish guidelines are measured in all participating centers.
Detailed Description
The investigators have developed an antibiotic stewardship program (ASP) to increase adherence to the Swedish guidelines for managing patients with a sore throat. This is a randomized controlled trial where primary health care centers are randomised to get the ASP or not. The adherence to the Swedish guidelines are measured in all participating centers 6 months before and after implementation of the ASP. The ASP consists of educational meetings at the clinic for medical practitioners and nurses being informed about current guidelines, seeing their clinics adherence to the guidelines as well as discussing cases.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Being a primary health care center in the Vastra Gotaland region, Sweden accepting participation
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
The effect of an ASP on the change in proportion of positive RADT among patients prescribed AB - 18m
Time Frame: Pre intervention 6 Months period compared to the 6 months period prior to follow-up at 18 months
The effect of an antibiotic stewardship program (ASP) on the proportion of patients prescribed antibiotics (J01 excluding methenamine) for a sore throat where a rapid antigen detection test (RADT) to detect Group A Streptococcus (GAS) is taken and is positive. Change from a 6 month period before initiation of the intervention (baseline) is compared with a time period of 6 months prior to the follow up date. The change from baseline to follow-up in all primary health care centres (PHCC) in the intervention group is compared to the corresponding change in PHCC in the control group (ASP group versus control group) using linear regression where adjustment will also be made for: the number of enlisted patients at baseline, location in cities versus small villages, Adjusted Clinical Group (ACG), Care-need index (CNI) and type of PHCC (private/public).
The effect of an ASP on the change in proportion of positive RADT among patients prescribed AB - 12m
Time Frame: Pre intervention 6 Months period compared to the 6 months period prior to follow-up at 12 months
The effect of an antibiotic stewardship program (ASP) on the proportion of patients prescribed antibiotics (J01 excluding methenamine) for a sore throat where a rapid antigen detection test (RADT) to detect Group A Streptococcus (GAS) is taken and is positive. Change from a 6 month period before initiation of the intervention (baseline) is compared with a time period of 6 months prior to the follow up date. The change from baseline to follow-up in all primary health care centres (PHCC) in the intervention group is compared to the corresponding change in PHCC in the control group (ASP group versus control group) using linear regression where adjustment will also be made for: the number of enlisted patients at baseline, location in cities versus small villages, Adjusted Clinical Group (ACG), Care-need index (CNI) and type of PHCC (private/public).
The effect of an ASP on the change in proportion of positive RADT among patients prescribed AB - 6m
Time Frame: Pre intervention 6 Months period compared to the 6 months period prior to follow-up at 6 months
The effect of an antibiotic stewardship program (ASP) on the proportion of patients prescribed antibiotics (J01 excluding methenamine) for a sore throat where a rapid antigen detection test (RADT) to detect Group A Streptococcus (GAS) is taken and is positive. Change from a 6 month period before initiation of the intervention (baseline) is compared with a time period of 6 months prior to the follow up date. The change from baseline to follow-up in all primary health care centres (PHCC) in the intervention group is compared to the corresponding change in PHCC in the control group (ASP group versus control group) using linear regression where adjustment will also be made for: the number of enlisted patients at baseline, location in cities versus small villages, Adjusted Clinical Group (ACG), Care-need index (CNI) and type of PHCC (private/public).
Secondary Outcomes
- The effect of an ASP on the change in proportion of negative RADT given AB - 12m(Pre intervention 6 Months period compared to the 6 months period prior to follow-up at 12 months)
- The effect of an ASP on the change in proportion of negative RADT given AB - 6m(Pre intervention 6 Months period compared to the 6 months period prior to follow-up at 6 months)
- The effect of an ASP on the change in proportion of recommended AB prescribed - 6m(Pre intervention 6 Months period compared to the 6 months period prior to follow-up at 6 months)
- The effect of an ASP on the change in proportion of negative RADT given AB - 18m(Pre intervention 6 Months period compared to the 6 months period prior to follow-up at 18 months)
- The effect of an ASP on the change in proportion of patients where CRP is requested - 18m(Pre intervention 6 Months period compared to the 6 months period prior to follow-up at 18 months)
- The effect of an ASP on the change in proportion of recommended AB prescribed - 12m(Pre intervention 6 Months period compared to the 6 months period prior to follow-up at 12 months)
- The effect of an ASP on the change in proportion of recommended AB prescribed - 18m(Pre intervention 6 Months period compared to the 6 months period prior to follow-up at 18 months)
- The effect of an ASP on the change in proportion of patients where CRP is requested - 6m(Pre intervention 6 Months period compared to the 6 months period prior to follow-up at 6 months)
- Proportion of patients with pharyngotonsillitis where a test for mononucleosis is taken(Pre intervention 6 Months period)
- The effect of an ASP on the change in proportion of patients where CRP is requested - 12m(Pre intervention 6 Months period compared to the 6 months period prior to follow-up at 12 months)
- Proportion of patients given AB for a sore throat with no throat swab taken(Pre intervention 6 Months period)
- Proportion of patients with pharyngotonsillitis where a throat swab is taken and sent for a culture(Pre intervention 6 Months period)