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Completed

NCT Number: NCT01240174

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 Electronic Health Record (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.

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Key information

Conditions

Bronchitis Bronchial Diseases Cough Infections Lung Diseases Lung Diseases, Obstructive Pathological Conditions, Signs and Symptoms Respiration Disorders Respiratory Tract Diseases Respiratory Tract Infections Signs and Symptoms Signs and Symptoms, Respiratory

Age range

18 year–64 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Brigham and Women's Hospital Jen Center for Primary Care

Boston, Massachusetts, 02115, United States

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Demonstration of near zero antibiotic prescribing for patients with acute bronchitis

Behavioral

A controlled, continuously-monitored, implementation of an EHR-integrated diagnosis and treatment algorithm for acute bronchitis in a large, diverse primary care practice.

Primary outcomes

  1. Antibiotic prescribing rate

    Time frame: 30 days

    The antibiotic prescribing rate for patients with acute bronchitis

Secondary outcomes

  1. Patient symptoms

    Time frame: 21 days

  2. Patient satisfaction

    Time frame: 21 days

  3. Patient safety

    Time frame: 30 days

  4. Healthcare costs

    Time frame: 30 days

  5. The capture and description of the components that had the greatest effect on the antimicrobial prescribing rate

    Time frame: 3 years

Sponsors and collaborators

Lead sponsor

Brigham and Women's Hospital

Other

Collaborators

  • Agency for Healthcare Research and Quality (AHRQ)

Registry information

Important dates

Study start
2011
Primary completion
2014
Study completion
2014
First posted
Nov 15, 2010
Registry last updated
Feb 1, 2017

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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