Evidence map›Paper›PMID 27491663›Full record

Trial reportBMJ open2016

Electronically delivered, multicomponent intervention to reduce unnecessary antibiotic prescribing for respiratory infections in primary care: a cluster randomised trial using electronic health records-REDUCE Trial study original protocol.

Dorota Juszczyk, Judith Charlton, Lisa McDermott, Jamie Soames, Kirin Sultana, Mark Ashworth, Robin Fox, Alastair D Hay, Paul Little, Michael V Moore and 3 more

Abstract readRandomized Controlled TrialPragmatic Clinical Trial
In one paragraph

Trial report in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Tailored interventions to address determinants of practice.The Cochrane database of systematic reviews · 2026
    Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Dorota JuszczykDepartment of Primary Care and Public Health Sciences, King's College London, London, UK.
Judith CharltonDepartment of Primary Care and Public Health Sciences, King's College London, London, UK.
Lisa McDermottDepartment of Primary Care and Public Health Sciences, King's College London, London, UK.
Jamie SoamesClinical Practice Research Datalink, Medicines and Healthcare Products Regulatory Agency, London, UK.
Kirin SultanaClinical Practice Research Datalink, Medicines and Healthcare Products Regulatory Agency, London, UK.
Mark AshworthDepartment of Primary Care and Public Health Sciences, King's College London, London, UK.
Robin FoxBicester Health Centre, Bicester, UK.
Alastair D HayCentre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK.
Paul LittlePrimary Care Research Group, University of Southampton, Southampton, UK.
Michael V MoorePrimary Care Research Group, University of Southampton, Southampton, UK.
Lucy YardleyDepartment of Psychology, University of Southampton, Southampton, UK.
A Toby PrevostDepartment of Primary Care and Public Health Sciences, King's College London, London, UK.
Martin C GullifordDepartment of Primary Care and Public Health Sciences, King's College London, London, UK.

Funding

Department of Health CDF-2009-02-10Department of Health HTA/13/88/10Department of Health NIHR-RP-02-12-012Department of Health RP-PG-0608-10018
6 · The paper itself

Abstract

introductionRespiratory tract infections (RTIs) account for about 60% of antibiotics prescribed in primary care. This study aims to test the effectiveness, in a cluster randomised controlled trial, of electronically delivered, multicomponent interventions to reduce unnecessary antibiotic prescribing when patients consult for RTIs in primary care. The research will specifically evaluate the effectiveness of feeding back electronic health records (EHRs) data to general practices. METHODS AND ANALYSIS: 2-arm cluster randomised trial using the EHRs of the Clinical Practice Research Datalink (CPRD). General practices in England, Scotland, Wales and Northern Ireland are being recruited and the general population of all ages represents the target population. Control trial arm practices will continue with usual care. Practices in the intervention arm will receive complex multicomponent interventions, delivered remotely to information systems, including (1) feedback of each practice's antibiotic prescribing through monthly antibiotic prescribing reports estimated from CPRD data; (2) delivery of educational and decision support tools; (3) a webinar to explain and promote effective usage of the intervention. The intervention will continue for 12 months. Outcomes will be evaluated from CPRD EHRs. The primary outcome will be the number of antibiotic prescriptions for RTIs per 1000 patient years. Secondary outcomes will be: the RTI consultation rate; the proportion of consultations for RTI with an antibiotic prescribed; subgroups of age; different categories of RTI and quartiles of intervention usage. There will be more than 80% power to detect an absolute reduction in antibiotic prescription for RTI of 12 per 1000 registered patient years. Total healthcare usage will be estimated from CPRD data and compared between trial arms. ETHICS AND DISSEMINATION: Trial protocol was approved by the National Research Ethics Service Committee (14/LO/1730). The pragmatic design of the trial will enable subsequent translation of effective interventions at scale in order to achieve population impact. TRIAL REGISTRATION NUMBER: ISRCTN95232781; Pre-results.

Indexed as

Practice Patterns, Physicians'Anti-Bacterial AgentsCluster AnalysisElectronic Health RecordsGeneral PracticeHumansInappropriate PrescribingPrimary Health CareReferral and ConsultationResearch DesignRespiratory Tract InfectionsUnited KingdomAnti-Bacterial AgentsAnti-Bacterial AgentsDrug ResistanceElectronic Health RecordsPrimary Health CareRandom AllocationRespiratory Tract Infections

Identifiers

PMID27491663
PMCPMC4985802

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.