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Improving Safe Antibiotic Prescribing in Telehealth

NCT05138874 · Status: COMPLETED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 6581

Last updated 2024-01-18

No results posted yet for this study

Summary

Appropriate use of antibiotics reduces resistance and protects patients from unnecessary harm. Important advances in antibiotic stewardship have been achieved in outpatient settings, but little is known about stewardship in the rapidly growing telehealth sector. Prior pragmatic randomized trials have shown that Centers for Disease Control (CDC) Core Element interventions constructed using insights from decision and social psychology can greatly reduce inappropriate prescribing in outpatient settings.

In a randomized trial, the investigators will adapt and test two aspects of CDC Core Elements in a telehealth environment (Teladoc®), each with two levels of intensity. Teladoc® clinicians will be randomized to the following interventions: 1) Performance Feedback (Trending, Benchmark Peer Comparison), 2) Commitment (Private, Public), or 3) Control. All randomization occurs at the provider level, with the exception of the Public Commitment arm, which requires patient-facing content that is determined by patient state. Clinicians and members will see the same messages across all pages, all channels \& all consults during the 12-month study period. The primary outcome is to assess change in antibiotic prescribing rate for qualifying acute respiratory infection visits (ARIs).

Conditions

  • Acute Respiratory Infection
  • Telehealth

Interventions

BEHAVIORAL

Trending Feedback

Clinicians randomized to Trending Feedback will receive monthly feedback on the provider dashboard page.

BEHAVIORAL

Benchmark Peer Comparison Feedback

Clinicians randomized to Benchmark Peer Comparison Feedback will receive monthly feedback on the provider dashboard page.

BEHAVIORAL

Private Commitment

Clinicians assigned to the Private Commitment will be prompted in the provider dashboard to make a personal commitment to evidence-based use of antibiotics that will not be shared with their patients.

BEHAVIORAL

Public Commitment

Clinicians assigned to Public Commitment will be prompted in the provider dashboard to make a commitment to evidence-based use of antibiotics that will be shared with their patients.

Sponsors & Collaborators

  • Agency for Healthcare Research and Quality (AHRQ)

    collaborator FED

  • Teladoc Health

    collaborator INDUSTRY

  • University of Southern California

    lead OTHER

Principal Investigators

  • Daniella Meeker, PhD · University of Southern California

Study Design

Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE
Model
FACTORIAL

Eligibility

Min Age
18 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2022-03-03
Primary Completion
2023-03-21
Completion
2023-09-21

Countries

  • United States

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT05138874 on ClinicalTrials.gov