Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial

Autor: Kerenza Hood, Jochen W L Cals, Geert-Jan Dinant, Christopher C Butler, Rogier M. Hopstaken
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Adult
Male
medicine.medical_specialty
RM
Patients
General Practice / Family Medicine
Point-of-care testing
Point-of-Care Systems
law.invention
Patient satisfaction
Professional Competence
Randomized controlled trial
law
Internal medicine
Lower respiratory tract infection
medicine
Cluster Analysis
Humans
Cluster randomised controlled trial
Medical prescription
Practice Patterns
Physicians'
Intensive care medicine
Respiratory Tract Infections
General Environmental Science
Antibacterial agent
Respiratory tract infections
business.industry
Communication
Research
General Engineering
General Medicine
medicine.disease
R1
Clinical Trials (Epidemiology)
Anti-Bacterial Agents
C-Reactive Protein
Infectious Diseases
Patient Satisfaction
General Earth and Planetary Sciences
Female
business
Family Practice
Biomarkers
Zdroj: The BMJ
ISSN: 8515-4857
0959-8138
Popis: OBJECTIVE: To assess the effect of general practitioner testing for C reactive protein (disease approach) and receiving training in enhanced communication skills (illness approach) on antibiotic prescribing for lower respiratory tract infection. DESIGN: Pragmatic, 2x2 factorial, cluster randomised controlled trial. SETTING: 20 general practices in the Netherlands. PARTICIPANTS: 40 general practitioners from 20 practices recruited 431 patients with lower respiratory tract infection. MAIN OUTCOME MEASURES: The primary outcome was antibiotic prescribing at the index consultation. Secondary outcomes were antibiotic prescribing during 28 days' follow-up, reconsultation, clinical recovery, and patients' satisfaction and enablement. INTERVENTIONS: General practitioners' use of C reactive protein point of care testing and training in enhanced communication skills separately and combined, and usual care. RESULTS: General practitioners in the C reactive protein test group prescribed antibiotics to 31% of patients compared with 53% in the no test group (P=0.02). General practitioners trained in enhanced communication skills prescribed antibiotics to 27% of patients compared with 54% in the no training group (P
Databáze: OpenAIRE
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