Knowledge support for optimising antibiotic prescribing for common infections in general practices: evaluation of the effectiveness of periodic feedback, decision support during consultations and peer comparisons in a cluster randomised trial (BRIT2) – study protocol Article Swipe
Tjeerd van Staa
,
Anita Sharma
,
Victoria Palin
,
Ali Fahmi
,
Harriet Cant
,
Xiaomin Zhong
,
Francine Jury
,
Natalie Gold
,
William Welfare
,
Darren M. Ashcroft
,
Jung Yin Tsang
,
Rachel Elliott
,
Chris Sutton
,
Christopher J. Armitage
,
Philip Couch
,
Georgina Moulton
,
Edward Tempest
,
Iain Buchan
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1136/bmjopen-2023-076296
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1136/bmjopen-2023-076296
Introduction This project applies a Learning Healthcare System (LHS) approach to antibiotic prescribing for common infections in primary care. The approach involves iterations of data analysis, feedback to clinicians and implementation of quality improvement activities by the clinicians. The main research question is, can a knowledge support system (KSS) intervention within an LHS implementation improve antibiotic prescribing without increasing the risk of complications? Methods and analysis A pragmatic cluster randomised controlled trial will be conducted, with randomisation of at least 112 general practices in North-West England. General practices participating in the trial will be randomised to the following interventions: periodic practice-level and individual prescriber feedback using dashboards; or the same dashboards plus a KSS. Data from large databases of healthcare records are used to characterise heterogeneity in antibiotic uses, and to calculate risk scores for clinical outcomes and for the effectiveness of different treatment strategies. The results provide the baseline content for the dashboards and KSS. The KSS comprises a display within the electronic health record used during the consultation; the prescriber (general practitioner or allied health professional) will answer standard questions about the patient’s presentation and will then be presented with information (eg, patient’s risk of complications from the infection) to guide decision making. The KSS can generate information sheets for patients, conveyed by the clinicians during consultations. The primary outcome is the practice-level rate of antibiotic prescribing (per 1000 patients) with secondary safety outcomes. The data from practices participating in the trial and the dashboard infrastructure will be held within regional shared care record systems of the National Health Service in the UK. Ethics and dissemination Approved by National Health Service Ethics Committee IRAS 290050. The research results will be published in peer-reviewed journals and also disseminated to participating clinical staff and policy and guideline developers. Trial registration number ISRCTN16230629 .
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1136/bmjopen-2023-076296
- https://bmjopen.bmj.com/content/bmjopen/13/8/e076296.full.pdf
- OA Status
- gold
- Cited By
- 9
- References
- 20
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4386071301
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4386071301Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1136/bmjopen-2023-076296Digital Object Identifier
- Title
-
Knowledge support for optimising antibiotic prescribing for common infections in general practices: evaluation of the effectiveness of periodic feedback, decision support during consultations and peer comparisons in a cluster randomised trial (BRIT2) – study protocolWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-08-01Full publication date if available
- Authors
-
Tjeerd van Staa, Anita Sharma, Victoria Palin, Ali Fahmi, Harriet Cant, Xiaomin Zhong, Francine Jury, Natalie Gold, William Welfare, Darren M. Ashcroft, Jung Yin Tsang, Rachel Elliott, Chris Sutton, Christopher J. Armitage, Philip Couch, Georgina Moulton, Edward Tempest, Iain BuchanList of authors in order
- Landing page
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https://doi.org/10.1136/bmjopen-2023-076296Publisher landing page
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-
https://bmjopen.bmj.com/content/bmjopen/13/8/e076296.full.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://bmjopen.bmj.com/content/bmjopen/13/8/e076296.full.pdfDirect OA link when available
- Concepts
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Medicine, Cluster randomised controlled trial, Alternative medicine, Randomized controlled trial, Cluster (spacecraft), Family medicine, Public health, Pediatrics, Nursing, Internal medicine, Pathology, Computer science, Programming languageTop concepts (fields/topics) attached by OpenAlex
- Cited by
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9Total citation count in OpenAlex
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2025: 3, 2024: 6Per-year citation counts (last 5 years)
- References (count)
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20Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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