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Demonstration of Near Zero Antibiotic Prescribing for Acute Bronchitis

This study is currently recruiting participants.
Verified June 2012 by Brigham and Women's Hospital
Sponsor:
Collaborator:
Agency for Healthcare Research and Quality (AHRQ)
Information provided by (Responsible Party):
Jeffrey A. Linder, Brigham and Women's Hospital
ClinicalTrials.gov Identifier:
NCT01240174
First received: November 10, 2010
Last updated: June 27, 2012
Last verified: June 2012
History of Changes

November 10, 2010
June 27, 2012
March 2011
June 2013   (final data collection date for primary outcome measure)
Antibiotic prescribing rate [ Time Frame: 30 days ] [ Designated as safety issue: No ]
The antibiotic prescribing rate for patients with acute bronchitis
Same as current
Complete list of historical versions of study NCT01240174 on ClinicalTrials.gov Archive Site
  • Patient symptoms [ Time Frame: 21 days ] [ Designated as safety issue: No ]
  • Patient satisfaction [ Time Frame: 21 days ] [ Designated as safety issue: No ]
  • Patient safety [ Time Frame: 30 days ] [ Designated as safety issue: No ]
  • Healthcare costs [ Time Frame: 30 days ] [ Designated as safety issue: No ]
  • The capture and description of the components that had the greatest effect on the antimicrobial prescribing rate [ Time Frame: 3 years ] [ Designated as safety issue: No ]
Same as current
 
 
 
Demonstration of Near Zero Antibiotic Prescribing for Acute Bronchitis
Demonstration of Near Zero Antibiotic Prescribing for Acute Bronchitis

Studies show, guidelines state, and performance measures assert that antibiotic prescribing for uncomplicated acute bronchitis is inappropriate. However, clinicians prescribe antimicrobials in over 60% of the 22.5 million acute bronchitis visits in the United States each year. Previous successful interventions have only reduced the antimicrobial prescribing rate to 40% or 50%. It is unknown if the antimicrobial prescribing rate for acute bronchitis can be brought to near zero percent in actual practice while maintaining patient safety and satisfaction. The goal of this study is to develop an EHR-integrated algorithm for the diagnosis and treatment of adults with acute bronchitis with a goal of reducing the antibiotic prescribing rate to near zero percent.
 
Interventional
 
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Health Services Research
  • Bronchitis
  • Cough
Behavioral: Demonstration of near zero antibiotic prescribing for patients with acute bronchitis
A controlled, continuously-monitored, implementation of an EHR-integrated diagnosis and treatment algorithm for acute bronchitis in a large, diverse primary care practice. We will use a multi-modal implementation - including computerized decision support, reporting tools, and clinician feedback - and quality improvement techniques to ensure adherence to the algorithm and reduce the antimicrobial prescribing rate to near zero percent. The duration of the intervention will be 4 years.
 
 

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
400
June 2014
June 2013   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • first visit in 30 days, age 18-64, has a cough of less than 3 weeks duration

Exclusion Criteria:

  • infiltrate on chest x-ray, has chronic lung disease
Both
18 Years to 64 Years
Yes
Contact: Alexandra C Businger 617-732-7063 abusinger@partners.org
United States
 
NCT01240174
2010P001247
No
Jeffrey A. Linder, Brigham and Women's Hospital
Brigham and Women's Hospital
Agency for Healthcare Research and Quality (AHRQ)
Principal Investigator: Jeffrey A Linder, MD, MPH Brigham and Women's Hospital, Harvard Medical School
Brigham and Women's Hospital
June 2012

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP