Infectious diseases experts as part of the antibiotic stewardship team in primary care: protocol for a cluster-randomised blinded study (IDASP)

Introduction: Antibiotic overuse is directly related to antibiotic resistance, and primary care is one of the main reasons for this overuse. This study aims to demonstrate that including experts on infectious diseases (ID) within the antimicrobial stewardship (AMS) programme team in primary care set...

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Autores: Ronda, Mar, Padullés Zamora, Ariadna, Simonet Aineto, Pere, Rodríguez Palomar, Gemma, Estrada, Cinta, Lérida, Ana, Ferro, Juan José, Cobo Sacristán, Sara, Tubau, Fe, Gardeñes, Lluïsa, Freixedas, Rosa, López Sans, Montserrat, Carrera, Elena, Pallarès, Natàlia, Tebé, Cristian, Carratalà, Jordi, Puig Asensio, Mireia, Shaw, Evelyn
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/181058
Acceso en línea:https://hdl.handle.net/2445/181058
Access Level:acceso abierto
Palabra clave:Utilització de medicaments
Prescripció de medicaments
Drug utilization
Drug prescribing
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spelling Infectious diseases experts as part of the antibiotic stewardship team in primary care: protocol for a cluster-randomised blinded study (IDASP)Ronda, MarPadullés Zamora, AriadnaSimonet Aineto, PereRodríguez Palomar, GemmaEstrada, CintaLérida, AnaFerro, Juan JoséCobo Sacristán, SaraTubau, FeGardeñes, LluïsaFreixedas, RosaLópez Sans, MontserratCarrera, ElenaPallarès, NatàliaTebé, CristianCarratalà, JordiPuig Asensio, MireiaShaw, EvelynUtilització de medicamentsPrescripció de medicamentsDrug utilizationDrug prescribingIntroduction: Antibiotic overuse is directly related to antibiotic resistance, and primary care is one of the main reasons for this overuse. This study aims to demonstrate that including experts on infectious diseases (ID) within the antimicrobial stewardship (AMS) programme team in primary care settings achieves higher reductions in overall antibiotic consumption and increases the quality of prescription. Methods and analysis: A multicentre, cluster-randomised, blinded clinical trial will be conducted between 2021 and 2023. Six primary care centres will be randomly assigned to an advanced or a standard AMS programme. The advanced AMS programme will consist of a standard AMS programme combined with the possibility that general practitioners (GP) will discuss patients' therapies with ID experts telephonically during working days and biweekly meetings. The main endpoint will be overall antibiotic consumption, defined as daily defined dose per 1000 inhabitants per day (DHD). Secondary end-points will be: (1) unnecessary antibiotic prescriptions in patients diagnosed with upper respiratory tract or urinary tract infection, (2) adequacy of antibiotic prescription, (3) reattendance to GP or emergency room within 30 days after the initial GP visit and (4) hospital admissions for any reason within 30 days after the GP visit. Two secondary endpoints (unnecessary antibiotic therapy and adequacy of therapy) will be evaluated by blinded investigators.We will select three clusters (centres) per arm (coverage of 147 644 inhabitants) which will allow the rejection of the null hypothesis of equal consumption with a power of 80%, assuming a moderate intracluster correlation of 0.2, an intracluster variance of 4 and a mean difference of 1 DHD. The type I error will be set at 5%.BMJ2021202120212021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion6 p.application/pdfhttps://hdl.handle.net/2445/181058Articles publicats en revistes (Ciències Clíniques)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1136/bmjopen-2021-053160BMJ Open, 2021, vol. 11, num. 10https://doi.org/10.1136/bmjopen-2021-053160cc by-nc (c) Ronda, Mar et al, 2021http://creativecommons.org/licenses/by-nc/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1810582026-05-29T05:05:01Z
dc.title.none.fl_str_mv Infectious diseases experts as part of the antibiotic stewardship team in primary care: protocol for a cluster-randomised blinded study (IDASP)
title Infectious diseases experts as part of the antibiotic stewardship team in primary care: protocol for a cluster-randomised blinded study (IDASP)
spellingShingle Infectious diseases experts as part of the antibiotic stewardship team in primary care: protocol for a cluster-randomised blinded study (IDASP)
Ronda, Mar
Utilització de medicaments
Prescripció de medicaments
Drug utilization
Drug prescribing
title_short Infectious diseases experts as part of the antibiotic stewardship team in primary care: protocol for a cluster-randomised blinded study (IDASP)
title_full Infectious diseases experts as part of the antibiotic stewardship team in primary care: protocol for a cluster-randomised blinded study (IDASP)
title_fullStr Infectious diseases experts as part of the antibiotic stewardship team in primary care: protocol for a cluster-randomised blinded study (IDASP)
title_full_unstemmed Infectious diseases experts as part of the antibiotic stewardship team in primary care: protocol for a cluster-randomised blinded study (IDASP)
title_sort Infectious diseases experts as part of the antibiotic stewardship team in primary care: protocol for a cluster-randomised blinded study (IDASP)
dc.creator.none.fl_str_mv Ronda, Mar
Padullés Zamora, Ariadna
Simonet Aineto, Pere
Rodríguez Palomar, Gemma
Estrada, Cinta
Lérida, Ana
Ferro, Juan José
Cobo Sacristán, Sara
Tubau, Fe
Gardeñes, Lluïsa
Freixedas, Rosa
López Sans, Montserrat
Carrera, Elena
Pallarès, Natàlia
Tebé, Cristian
Carratalà, Jordi
Puig Asensio, Mireia
Shaw, Evelyn
author Ronda, Mar
author_facet Ronda, Mar
Padullés Zamora, Ariadna
Simonet Aineto, Pere
Rodríguez Palomar, Gemma
Estrada, Cinta
Lérida, Ana
Ferro, Juan José
Cobo Sacristán, Sara
Tubau, Fe
Gardeñes, Lluïsa
Freixedas, Rosa
López Sans, Montserrat
Carrera, Elena
Pallarès, Natàlia
Tebé, Cristian
Carratalà, Jordi
Puig Asensio, Mireia
Shaw, Evelyn
author_role author
author2 Padullés Zamora, Ariadna
Simonet Aineto, Pere
Rodríguez Palomar, Gemma
Estrada, Cinta
Lérida, Ana
Ferro, Juan José
Cobo Sacristán, Sara
Tubau, Fe
Gardeñes, Lluïsa
Freixedas, Rosa
López Sans, Montserrat
Carrera, Elena
Pallarès, Natàlia
Tebé, Cristian
Carratalà, Jordi
Puig Asensio, Mireia
Shaw, Evelyn
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Utilització de medicaments
Prescripció de medicaments
Drug utilization
Drug prescribing
topic Utilització de medicaments
Prescripció de medicaments
Drug utilization
Drug prescribing
description Introduction: Antibiotic overuse is directly related to antibiotic resistance, and primary care is one of the main reasons for this overuse. This study aims to demonstrate that including experts on infectious diseases (ID) within the antimicrobial stewardship (AMS) programme team in primary care settings achieves higher reductions in overall antibiotic consumption and increases the quality of prescription. Methods and analysis: A multicentre, cluster-randomised, blinded clinical trial will be conducted between 2021 and 2023. Six primary care centres will be randomly assigned to an advanced or a standard AMS programme. The advanced AMS programme will consist of a standard AMS programme combined with the possibility that general practitioners (GP) will discuss patients' therapies with ID experts telephonically during working days and biweekly meetings. The main endpoint will be overall antibiotic consumption, defined as daily defined dose per 1000 inhabitants per day (DHD). Secondary end-points will be: (1) unnecessary antibiotic prescriptions in patients diagnosed with upper respiratory tract or urinary tract infection, (2) adequacy of antibiotic prescription, (3) reattendance to GP or emergency room within 30 days after the initial GP visit and (4) hospital admissions for any reason within 30 days after the GP visit. Two secondary endpoints (unnecessary antibiotic therapy and adequacy of therapy) will be evaluated by blinded investigators.We will select three clusters (centres) per arm (coverage of 147 644 inhabitants) which will allow the rejection of the null hypothesis of equal consumption with a power of 80%, assuming a moderate intracluster correlation of 0.2, an intracluster variance of 4 and a mean difference of 1 DHD. The type I error will be set at 5%.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/181058
url https://hdl.handle.net/2445/181058
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1136/bmjopen-2021-053160
BMJ Open, 2021, vol. 11, num. 10
https://doi.org/10.1136/bmjopen-2021-053160
dc.rights.none.fl_str_mv cc by-nc (c) Ronda, Mar et al, 2021
http://creativecommons.org/licenses/by-nc/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc (c) Ronda, Mar et al, 2021
http://creativecommons.org/licenses/by-nc/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 6 p.
application/pdf
dc.publisher.none.fl_str_mv BMJ
publisher.none.fl_str_mv BMJ
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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