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Study Title and Description

Training family physicians in shared decision-making to reduce the overuse of antibiotics in acute respiratory infections: a cluster randomized 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 to reduce the overuse of antibiotics in acute respiratory infections: a cluster randomized trial.
Author Légaré F., Labrecque M., Cauchon M., Castel J., Turcotte S., Grimshaw J.
Country Research Centre of the Centre Hospitalier Universitaire de Québec, Québec, Canada. france.legare@mfa.ulaval.ca
Year 2012
Numbers Pubmed ID: 22847969

Secondary Publication Information
UI Title Author Country Year
Impact of DECISION + 2 on patient and physician assessment of shared decision making implementation in the context of antibiotics use for acute respiratory infections. Légaré F., Guerrier M., Nadeau C., Rhéaume C., Turcotte S., Labrecque M. Research Center of the Centre Hospitalier Universitaire de Québec, Hôpital St-François d'Assise, 10, Rue Espinay, Quebec City, QC G1L 3 L5, Canada. France.legare@mfa.ulaval.ca. 2013
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Extraction Form: Interventions to Reduce Antibiotic Prescribing for Uncomplicated Acute Respiratory Tract Infections Extraction Form


Results & Comparisons

No Results found.