| Title: |
A multifaceted intervention to reduce antibiotic prescribing among CHIldren with acute COugh and respiratory tract infection: the CHICO cluster RCT |
| Authors: |
Blair, Peter S.; Young, Grace J.; Clement, Clare; Dixon, Padraig; Seume, Penny; Ingram, Jenny; Taylor, Jodi; Horwood, Jeremy; Lucas, Patricia J.; Cabral, Christie; Francis, Nick A.; Beech, Elizabeth; Gulliford, Martin; Creavin, Sam; Lane, Janet A.; Bevan, Scott; Hay, Alastair D. |
| Publication Year: |
2023 |
| Collection: |
University of Southampton: e-Prints Soton |
| Description: |
BACKGROUND: Clinical uncertainty in primary care regarding the prognosis of children with respiratory tract infections contributes to the unnecessary use of antibiotics. Improved identification of children at low risk of future hospitalisation might reduce clinical uncertainty. A National Institute for Health and Care Research-funded 5-year programme (RP-PG-0608-10018) was used to develop and feasibility test an intervention. OBJECTIVES: The aim of the children with acute cough randomised controlled trial was to reduce antibiotic prescribing among children presenting with acute cough and respiratory tract infection without increasing hospital admission. DESIGN: An efficient, pragmatic open-label, two-arm trial (with embedded qualitative and health economic analyses) using practice-level randomisation using routinely collected data as the primary outcome. SETTING: General practitioner practices in England. PARTICIPANTS: General practitioner practices using the Egton Medical Information Systems ® patient-record system for children aged 0-9 years presenting with a cough or upper respiratory tract infection. Recruited by Clinical Research Networks and Clinical Commissioning Groups. INTERVENTION: Comprised: (1) elicitation of parental concerns during consultation; (2) a clinician-focused prognostic algorithm to identify children with acute cough and respiratory tract infection at low, average or elevated risk of hospitalisation in the next 30 days accompanied by prescribing guidance, (3) provision of a printout for carers including safety-netting advice. MAIN OUTCOME MEASURES: Co-primaries using the practice list-size for children aged 0-9 years as the denominator: rate of dispensed amoxicillin and macrolide items at each practice (superiority comparison) from NHS Business Services Authority ePACT2 and rate of hospital admission for respiratory tract infection (non-inferiority comparison) from Clinical Commissioning Groups, both routinely collected over 12 months. RESULTS: Of the 310 practices required, 294 (95%) ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://eprints.soton.ac.uk/486470/1/3044518.pdf; Blair, Peter S., Young, Grace J., Clement, Clare, Dixon, Padraig, Seume, Penny, Ingram, Jenny, Taylor, Jodi, Horwood, Jeremy, Lucas, Patricia J., Cabral, Christie, Francis, Nick A., Beech, Elizabeth, Gulliford, Martin, Creavin, Sam, Lane, Janet A., Bevan, Scott and Hay, Alastair D. (2023) A multifaceted intervention to reduce antibiotic prescribing among CHIldren with acute COugh and respiratory tract infection: the CHICO cluster RCT. Health Technology Assessment, 27 (32). (doi:10.3310/UCTH3411 ). |
| Availability: |
https://eprints.soton.ac.uk/486470/; https://eprints.soton.ac.uk/486470/1/3044518.pdf |
| Rights: |
cc_by_4 |
| Accession Number: |
edsbas.DFDFD5A |
| Database: |
BASE |