Trial reportBMJ open2016
Primary care randomised controlled trial of a tailored interactive website for the self-management of respiratory infections (Internet Doctor).
Trial report in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 23 papers, 4 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
23 citing papers in PubMed, 4 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Guideline
- Systematic review of patient-oriented interventions to reduce unnecessary use of antibiotics for upper respiratory tract infections.Systematic reviews · 2020Pooled it
- Digital interventions for parents of acutely ill children and their treatment-seeking behaviour: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Pooled it
- Digital and online symptom checkers and health assessment/triage services for urgent health problems: systematic review.BMJ open · 2019Pooled it
- The REDUCE Intervention: The Development of a Person-Centred Cognitive Behavioural Intervention to Improve Ulcer Outcomes in People at Risk of Diabetic Foot Ulceration.Health expectations : an international journal of public participation in health care and health policy · 2025Trial
- Improving pain management in childhood acute otitis media in general practice: a cluster randomised controlled trial of a GP-targeted educational intervention.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Trial
- The 2023 Garrod Lecture: Antimicrobial use and stewardship in primary care: what works, and what next?The Journal of antimicrobial chemotherapy · 2025Article
- Article
- Post-resolution macrophages shape long-term tissue immunity and integrity in a mouse model of pneumococcal pneumonia.Nature communications · 2024Article
- NSAID prescribing and adverse outcomes in common infections: a population-based cohort study.BMJ open · 2024Article
- Full-dose NSAIDs at the first sign of respiratory infection?The Lancet. Infectious diseases · 2022Article
- Efficacy and Safety of NSAIDs in Infants: A Comprehensive Review of the Literature of the Past 20 Years.Paediatric drugs · 2022Review
- A Digital Intervention for Respiratory Tract Infections (Internet Dr): Process Evaluation to Understand How to Support Self-care for Minor Ailments.JMIR formative research · 2022Article
- Empowering Patients to Self-Manage Common Infections: Qualitative Study Informing the Development of an Evidence-Based Patient Information Leaflet.Antibiotics (Basel, Switzerland) · 2021Article
- Taizhou's COVID-19 prevention and control experience with telemedicine features.Frontiers of medicine · 2020Article
- Rapid Review: Nonsteroidal Anti-inflammatory Agents and Aminosalicylates in COVID-19 Infections.Journal of clinical gastroenterology · 2020Article
- The anti-viral facet of anti-rheumatic drugs: Lessons from COVID-19.Journal of autoimmunity · 2020Review
- Respiratory tract infection-related healthcare utilisation in children with Down's syndrome.Infection · 2020Article
- Clustering of continuous and binary outcomes at the general practice level in individually randomised studies in primary care - a review of 10 years of primary care trials.BMC medical research methodology · 2020Review
- Internet Hospitals Help Prevent and Control the Epidemic of COVID-19 in China: Multicenter User Profiling Study.Journal of medical Internet research · 2020Article
Corrections and comments
- Commented on by
- Erratum issuedCorrection.2017
Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo assess an internet-delivered intervention providing advice to manage respiratory tract infections (RTIs).
designOpen pragmatic parallel group randomised controlled trial.
settingPrimary care in UK.
participantsAdults (aged ≥18) registered with general practitioners, recruited by postal invitation.
interventionPatients were randomised with computer-generated random numbers to access the intervention website (intervention) or not (control). The intervention tailored advice about the diagnosis, natural history, symptom management (particularly paracetamol/ibuprofen use) and when to seek further help. OUTCOMES: Primary: National Health Service (NHS) contacts for those reporting RTIs from monthly online questionnaires for 20 weeks. Secondary: hospitalisations; symptom duration/severity.
resultsResults 3044 participants were recruited. 852 in the intervention group and 920 in the control group reported one or more RTIs, among whom there a modest increase in NHS Direct contacts in the intervention group (intervention 44/1734 (2.5%) versus control 24/1842 (1.3%); multivariate Risk Ratio (RR) 2.53 (95% CI 1.10 to 5.82, p=0.029)). Conversely reduced contact with doctors occurred (283/1734 (16.3%) vs 368/1845 (20.0%); risk ratio 0.71, 0.53 to 0.95, p=0.019). Reduction in contacts occurred despite slightly longer illness duration (11.3 days versus 10.9 days respectively; multivariateestimate 0.48 days longer (-0.16 to 1.12, p=0.141) and more days of illness rated moderately bad or worse illness (0.53 days; 0.12 to 0.94, p=0.012). The estimate of slower symptom resolution in the intervention group was attenuated when controlling for whether individuals had used webpages which advocated ibuprofen use (length of illness 0.22 days, −0.51 to 0.95, p=0.551; moderately bad or worse symptoms 0.36 days, −0.08 to 0.80, p=0.105). There was no evidence of increased hospitalisations (risk ratio 0.13; 0.02 to 1.01; p=0.051).
conclusionsAn internet-delivered intervention for the self-management of RTIs modifies help-seeking behaviour, and does not result in more hospital admissions due to delayed help seeking. Advising the use of ibuprofen may not be helpful. TRIAL REGISTRATION NUMBER: ISRCTN91518452.
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.