Trial reportBMC health services research2014
Process evaluation of a point-of-care cluster randomised trial using a computer-delivered intervention to reduce antibiotic prescribing in primary care.
Trial report in BMC health services research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 6 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
19 citing papers in PubMed, 6 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
- Pooled 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
- Stakeholder Perspectives of Clinical Artificial Intelligence Implementation: Systematic Review of Qualitative Evidence.Journal of medical Internet research · 2023Pooled it
- The effects of clinical decision support system for prescribing medication on patient outcomes and physician practice performance: a systematic review and meta-analysis.BMC medical informatics and decision making · 2021Pooled it
- Antibiotic prescribing for acute respiratory tract infections in primary care: an updated and expanded meta-ethnography.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Pooled it
- 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
- Trial
- Trial
- Do process evaluations open up the 'black box' of implementation interventions in health care? A scoping review.Implementation science : IS · 2025Article
- The role of electronic health records systems in de-implementing low-value care in primary care: a scoping review.Implementation science communications · 2025Review
- Initial Treatment and Referral Patterns for Acute Facial Palsy: Insights From Emergency Department Practices.The Laryngoscope · 2025Article
- Developing a data-enabled nudge intervention for childhood antibiotics in primary care: a qualitative study.BJGP open · 2025Article
- Theoretically derived interventions aimed at improving appropriate polypharmacy in primary care: A systematic review.Exploratory research in clinical and social pharmacy · 2022Review
- E-Health Tools to Improve Antibiotic Use and Resistances: A Systematic Review.Antibiotics (Basel, Switzerland) · 2020Review
- Paving the Way for the Implementation of a Decision Support System for Antibiotic Prescribing in Primary Care in West Africa: Preimplementation and Co-Design Workshop With Physicians.Journal of medical Internet research · 2020Article
- The GUIDES checklist: development of a tool to improve the successful use of guideline-based computerised clinical decision support.Implementation science : IS · 2018Article
- Thinking Together: Modeling Clinical Decision-Support as a Sociotechnical System.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2017Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundThe study aimed to conduct a process evaluation for a cluster randomised trial of a computer-delivered, point-of-care intervention to reduce antibiotic prescribing in primary care. The study aimed to evaluate both the intervention and implementation of the trial.
methodsThe intervention comprised a set of electronic educational and decision support tools that were remotely installed and activated during consultations with patients with acute respiratory infections over a 12 month intervention period. A mixed method evaluation was conducted with 103 general practitioners (GPs) who participated in the trial. Semi-structured telephone interviews were conducted with 20 GPs who had been in the intervention group of the trial and 4 members of the implementation staff. Questionnaires, consisting of both intervention evaluation and theory-based measures, were self-administered to 83 GPs (56 control group and 27 intervention group).
resultsInterviews suggested that a key factor influencing GPs' use of the intervention appeared to be their awareness of the implementation of the system into their practice. GPs who were aware of the implementation of the intervention reported feeling confident in using it if they chose to and understood the purpose of the intervention screens. However, GPs who were unaware that the intervention would be appearing often reported feeling confused when they saw the messages appear on the screen and not fully understanding what they were for or how they could be used. Intervention evaluation questionnaires indicated that GPs were satisfied with the usability of the prompts, and theory-based measures revealed that intervention group GPs reported higher levels of self-efficacy in managing RTI patients according to recommended guidelines compared to GPs in the control group.
conclusionsRemote installation of a computer-delivered intervention for use at the point-of-care was feasible and acceptable. Additional measures to promote awareness of the intervention may be required to promote health care professionals' utilisation of the intervention and these might sometimes compromise the pragmatic intention of a trial.
trial registrationISRCTN47558792 (registered on 17 March 2010).
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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.