Trial reportAnnals of family medicine2014
Electronic health records for intervention research: a cluster randomized trial to reduce antibiotic prescribing in primary care (eCRT study).
Trial report in Annals of family medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 10 syntheses or guidelines pooled it.
- Implementation, adoption and impact of clinical decision support system for antibiotic prescribing in primary care: a systematic review.The Journal of antimicrobial chemotherapy · 2026Pooled it
- Digital patient safety interventions in primary care: a systematic review and meta-analysis.BMC medicine · 2026Pooled it
- Pooled it
- Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2024Pooled it
- Improving healthcare professionals' interactions with patients to tackle antimicrobial resistance: a systematic review of interventions, barriers, and facilitators.Frontiers in public health · 2024Pooled it
- Effectiveness of decision support tools on reducing antibiotic use for respiratory tract infections: a systematic review and meta-analysis.Frontiers in pharmacology · 2023Pooled it
- Antibiotic prescribing in inpatient and outpatient settings in Iran: a systematic review and meta-analysis study.Antimicrobial resistance and infection control · 2021Pooled it
- The effects of the primary health care providers' prescription behavior interventions to improve the rational use of antibiotics: a systematic review.Global health research and policy · 2020Pooled it
- Reduction of antibiotic prescriptions for acute respiratory tract infections in primary care: a systematic review.Implementation science : IS · 2018Pooled it
- The effects of on-screen, point of care computer reminders on processes and outcomes of care.The Cochrane database of systematic reviews · 2009Pooled it
- A multifaceted intervention to reduce antibiotic prescribing among CHIldren with acute COugh and respiratory tract infection: the CHICO cluster RCT.Health technology assessment (Winchester, England) · 2023Trial
- Effectiveness and safety of electronically delivered prescribing feedback and decision support on antibiotic use for respiratory illness in primary care: REDUCE cluster randomised trial.BMJ (Clinical research ed.) · 2019Trial
- Automated recruitment and randomisation for an efficient randomised controlled trial in primary care.Trials · 2018Trial
- Trial
- The impact of an electronic learning intervention to support appropriate antibiotic prescribing behaviour by non-medical prescribers for upper respiratory tract infections in the primary care setting: a feasibility study.BMC health services research · 2025Article
- Article
- Developing a data-enabled nudge intervention for childhood antibiotics in primary care: a qualitative study.BJGP open · 2025Article
- Effectiveness of different de-implementation strategies in primary care: systematic review and meta-analysis.BMJ medicine · 2025Article
- Reporting of costs and economic impacts in randomized trials of de-implementation interventions for low-value care: a systematic scoping review.Implementation science : IS · 2023Article
- Refinement of a pharmacogenomics app for dosing guidelines for oncology: findings from the usability evaluation.Annals of translational medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
purposeThis study aimed to implement a point-of-care cluster randomized trial using electronic health records. We evaluated the effectiveness of electronically delivered decision support tools at reducing antibiotic prescribing for respiratory tract infections in primary care.
methodsFamily practices from England and Scotland participating in the Clinical Practice Research Datalink (CPRD) were included in the trial; 53 family practices were allocated to intervention and 51 practices were allocated to usual care. Patients aged 18 to 59 years consulting for respiratory tract infections were eligible. The intervention was through remotely installed, computer-delivered decision support tools accessed during the consultations. Control practices provided usual care. The primary outcome was the proportion of consultations for respiratory tract infections with an antibiotic prescribed based on electronic health records. Family practice-specific proportions were included in a cluster-level analysis.
resultsData were analyzed for 603,409 patients: 317,717 at intervention practices and 285,692 at control practices. Use of the intervention was less than anticipated, varying among practices. There was a reduction in proportion of consultations with antibiotics prescribed of 1.85% (95% CI, 0.10%-3.59%, P=.038) and in the rate of antibiotic prescribing for respiratory tract infections (9.69%; 95% CI, 0.75%-18.63%, fewer prescriptions per 1,000 patient-years, P=.034). There were no adverse events.
conclusionsCluster randomized trials may be implemented efficiently in large samples from routine care settings by using primary care electronic health records. Future studies should develop and test multicomponent methods for remotely delivered intervention.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.