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Active, Not Recruiting

NCT Number: NCT06144242

Improving Antibiotic Use for ARIs in Urgent Care Clinics

Many clinicians prescribe antibiotics for patients with acute respiratory infections even when antibiotics will not benefit the patient because the infection is due to a virus. To discourage this type of unnecessary antibiotic use, the investigators will assess whether it is helpful to give clinicians feedback on how often they prescribe antibiotics for respiratory infections in comparison to their peers. The investigators will perform this study across Urgent Care and QuickCare clinics within a single healthcare system.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

Key information

Conditions

Antibacterial Agents Ambulatory Care

Age range

21 year–99 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Iowa Hospitals and Clinics

Iowa City, Iowa, 52242, United States

About this study

The investigators have used an established HEDIS (Healthcare Effectiveness Data and Information Set) metric to evaluate Urgent Care and QuickCare clinicians on their antibiotic use for respiratory tract diagnoses (RTDs). This RTD metric excludes visits that are more complicated, based on well-defined criteria. Based on our baseline assessment (2018-2022), the investigators estimate that most clinicians in this setting are frequently prescribing unnecessary antibiotics.

The investigators will perform a randomized controlled trial to assess whether providing individualized feedback to clinicians on the RTD metric can safely reduce antibiotic use for qualifying respiratory tract visits across Urgent and QuickCare settings within a single integrated healthcare system. Clinicians who do not opt-out of the trial will be randomized to either receive feedback or not receive feedback on this RTD metric. The trial will last for 18 months. The primary outcome of effectiveness will be the frequency of antibiotic-prescribing for RTD visits. Secondary outcomes include total antibiotic use (regardless of diagnosis), changes in the use of diagnostic codes, 30-day rates of follow-up visits and hospital admissions. The RE-AIM framework will be used to guide additional study evaluation.

Who can participate

Healthy volunteers accepted: Yes

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

Any clinician who works in Urgent Care or QuickCare clinics within our healthcare system.

Treatment and study plan

Feedback on RTD metric

Behavioral

Clinicians in the experimental arm will receive feedback on the RTD metric while clinicians in the No intervention arm will not.

Primary outcomes

  1. Frequency of antibiotic-prescribing for RTD visits

    Time frame: 24 hours of visit

    Percentage of all qualifying respiratory tract diagnosis (RTD) visits prescribed an antibiotic

Secondary outcomes

  1. Frequency of antibiotic-prescribing for all visits

    Time frame: 24 hours of visit

    Percentage of all visits prescribed an antibiotic, regardless of the diagnosis

  2. Follow-up visit to Urgent Care or QuickCare

    Time frame: 30 days

    Percentage of patients with a qualifying RTD visit who were seen at least once in Urgent Care or QuickCare within the 30 days after their index visit date.

  3. Follow-up Emergency Department visit and/or acute-care hospitalization

    Time frame: 30 days

    Percentage of patients with a qualifying RTD visit who were seen at least once in the Emergency Department and/or who were hospitalized (any reason) within the 30 days after their index visit date.

Sponsors and collaborators

Lead sponsor

Daniel Livorsi

Other

Registry information

Official study title

Randomized-controlled Trial to Assess Whether Feedback on a New Stewardship Metric Can Improve Antibiotic-prescribing for Acute Respiratory Tract Infections in Urgent Care Clinics

Important dates

Study start
2024
Primary completion
2025
Study completion
2026
First posted
Nov 22, 2023
Registry last updated
Dec 24, 2025

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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