Resetting the Default: Improving Provider-patient Communication to Reduce Antibiotic Misuse

Summary

Antibiotic overuse and misuse contributes to the development of antibiotic resistant infections and adverse drug reactions. The majority of all antibiotic prescribing occurs in outpatient settings; most of which are for respiratory illnesses. It is estimated that 50% of these prescriptions are unnecessary. The most important factor that leads to overprescribing is inadequate parent-provider communication. This study will recruit providers and eligible parents of children 1-5 years of age. Parents in both arms will receive identical brief antibiotic education via tablet computers. Providers will be randomized to the parent-provider education or communication skills intervention arm and trained accordingly. Parent data will be collected via a tablet computer RedCap survey administered in the exam room prior and immediately following the child's visit. Additional data will be garnered from the medical record (antibiotic prescribing) and a 2-week follow-up telephone call with parents (re-visits and adverse drug reactions).

Conditions

• Communication
• Anti-Bacterial Agents
• Decision Making
• Personal Satisfaction

Interventions

BEHAVIORAL

Education

The first intervention is an educational intervention regarding appropriate diagnosis and treatment of common respiratory infections. This education will be delivered in an interactive lecture format for providers with follow up short informational video clips available over the course of the project.

BEHAVIORAL

Communication Skills

The second intervention is an education plus communication skills training intervention. This training session will include identical antibiotic education training, good and bad communication examples, training on negative behavioral framing, and education regarding key drivers of patient satisfaction. Additionally providers will be informed of parent's desire for antibiotics rating prior to their consultation with the patient.

Sponsors & Collaborators

• Heartland Primary Care of Sunflower Medical Group

  collaborator UNKNOWN

• Washington University School of Medicine

  collaborator OTHER

• Patient-Centered Outcomes Research Institute

  collaborator OTHER

• Children's Mercy Hospital Kansas City

  lead OTHER

Principal Investigators

• Kathy Goggin, PhD · Childrens Mercy Hospital

• Jason G. Newland, MD · Washington University School of Medicine

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2017-03-03

Primary Completion

2019-03-20

Completion

2019-04-30

Countries

• United States

Study Locations