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Study Title and Description

Training family physicians in shared decision making for the use of antibiotics for acute respiratory infections: a pilot clustered randomized controlled trial.



Key Questions Addressed
1 Key Question 1. For patients with an acute respiratory tract infection and no clear indication for antibiotic treatment, what is the comparative effectiveness of particular strategies in improving the appropriate prescription or use of antibiotics compared with other strategies or standard care? a) Does the comparative effectiveness of strategies differ according to how appropriateness is defined? b) Does the comparative effectiveness of strategies differ according to the intended target of the strategy (i.e., clinicians, patients, and both)? c) Does the comparative effectiveness of strategies differ according to patient characteristics, such as type of respiratory tract infection, signs and symptoms (nature and duration), when counting began for duration of symptoms, previous medical history (e.g., frailty, comorbidity), prior respiratory tract infections, prior use of antibiotics, age, ethnicity, socioeconomic status, and educational level attained? d) Does the comparative effectiveness of strategies differ according to clinician characteristics, such as specialty, number of years in practice, type of clinic organization, geographic region, and population served? e) Does the comparative effectiveness differ according to the diagnostic method or definition used, the clinician’s perception of the patient’s illness severity, or the clinician’s diagnostic certainty? f) Does the comparative effectiveness differ according to various background contextual factors, such as the time of year, known patterns of disease activity (e.g., an influenza epidemic, a pertussis outbreak), system level characteristics, or whether the intervention was locally tailored?
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4 Key Question 4. For patients with an acute respiratory tract infection and no clear indication for antibiotic treatment, what is the comparative effect of particular strategies on other clinical outcomes (e.g., health care utilization, patient satisfaction) compared with other strategies or standard care? a) Does the comparative effect of strategies differ according to the intended target of the strategy (i.e., clinicians, patients, and both)? b) Does the comparative effect of strategies differ according to patient characteristics, such as type of respiratory tract infection, signs and symptoms (nature and duration), when counting began for duration of symptoms, previous medical history (e.g., frailty, comorbidity), prior respiratory tract infections, prior use of antibiotics, age, ethnicity, socioeconomic status, and educational level attained? c) Does the comparative effect of strategies differ according to clinician characteristics, such as specialty, number of years in practice, type of clinic organization, geographic region, and population served? d) Does the comparative effectiveness differ according to the diagnostic method or definition used, the clinician’s perception of the patient’s illness severity, or the clinician’s diagnostic certainty? e) Does the comparative effect differ according to various background contextual factors, such as the time of year, known patterns of disease activity (e.g., an influenza epidemic, a pertussis outbreak), whether the intervention was locally tailored or system-level characteristics?
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5 Key Question 5. For patients with an acute respiratory tract infection and no clear indication for antibiotic treatment, what is the comparative effect of particular strategies on achieving intended intermediate outcomes, such as improved knowledge regarding use of antibiotics for acute respiratory tract infections (clinicians and/or patients), improved shared decisionmaking regarding the use of antibiotics, and improved clinician skills for appropriate antibiotic use (e.g., communication appropriate for patients’ literacy level and/or cultural background)?
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Primary Publication Information
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TitleData
Title Training family physicians in shared decision making for the use of antibiotics for acute respiratory infections: a pilot clustered randomized controlled trial.
Author Légaré F., Labrecque M., LeBlanc A., Njoya M., Laurier C., Côté L., Godin G., Thivierge RL., O'Connor A., St-Jacques S.
Country Research Centre of the Centre Hospitalier Universitaire de Québec, Québec, QC, Canada. france.legare@mfa.ulaval.ca
Year 2011
Numbers Pubmed ID: 20629764

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: Interventions to Reduce Antibiotic Prescribing for Uncomplicated Acute Respiratory Tract Infections Extraction Form


Results & Comparisons

No Results found.