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Study Title and Description

Documentation-based clinical decision support to improve antibiotic prescribing for acute respiratory infections in primary care: a cluster randomised 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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Primary Publication Information
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TitleData
Title Documentation-based clinical decision support to improve antibiotic prescribing for acute respiratory infections in primary care: a cluster randomised controlled trial.
Author Linder JA., Schnipper JL., Tsurikova R., Yu T., Volk LA., Melnikas AJ., Palchuk MB., Olsha-Yehiav M., Middleton B.
Country Division of General Medicine and Primary Care, Brigham and Women's Hospital, 1620 Tremont Street, BC-3-2X, Boston, MA 02120, USA. jlinder@partners.org
Year 2009
Numbers Pubmed ID: 20359401

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.