Evidence map›Paper›PMID 35724841›Full record

ArticleContemporary clinical trials2022

The protocol of improving safe antibiotic prescribing in telehealth: A randomized trial.

Bridget K McCabe, Jeffrey A Linder, Jason N Doctor, Mark Friedberg, Craig R Fox, Noah J Goldstein, Tara K Knight, Katrina Kaiser, Jason Tibbels, Steve Haenchen and 3 more

Erratum issued Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in Contemporary clinical trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT05138874 (Improving Safe Antibiotic Prescribing in Telehealth), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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.

NCT05138874 nacompletednot on this map

Improving Safe Antibiotic Prescribing in Telehealth: Evaluation of a Randomized Trial

TypeinterventionalSponsorUniversity of Southern CaliforniaRan2022 to 2023Enrolled6,581ConditionsAcute Respiratory Infection, TelehealthArmsTrending Feedback, Benchmark Peer Comparison Feedback, Private Commitment, Public Commitment
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Bridget K McCabeTeladoc Health, Inc., Purchase, NY; United States of America.
Jeffrey A LinderDivision of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
Jason N DoctorLeonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, CA, United States of America; Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, United States of America.
Mark FriedbergBlue Cross Blue Shield of Massachusetts, Boston, MA, United States of America.
Craig R FoxAnderson School of Management, University of California at Los Angeles, Los Angeles, CA, United States of America.
Noah J GoldsteinAnderson School of Management, University of California at Los Angeles, Los Angeles, CA, United States of America.
Tara K KnightLeonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, CA, United States of America; Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, United States of America.
Katrina KaiserLeonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, CA, United States of America; Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, United States of America.
Jason TibbelsTeladoc Health, Inc., Purchase, NY; United States of America.
Steve HaenchenTeladoc Health, Inc., Purchase, NY; United States of America.
Stephen D PersellDivision of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
Rebecca WarbergTeladoc Health, Inc., Purchase, NY; United States of America.
Daniella MeekerLeonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, CA, United States of America; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America. Electronic address: dmeeker@usc.edu.

Funding

Improving Safe Antibiotic Prescribing in Telehealth: A Randomized TrialR01HS026506 · AHRQ · YALE UNIVERSITY · PI MEEKER, DANIELLA · 2018 to 2022
$2.1M
AHRQ HHS R01 HS026506
6 · The paper itself

Abstract

backgroundThe CDC estimates that over 40% of Urgent Care visits are for acute respiratory infections (ARI), more than half involving inappropriate antibiotic prescriptions. Previous randomized trials in primary care clinics resulted in reductions in inappropriate antibiotic prescribing, but antibiotic stewardship interventions in telehealth have not been systematically assessed. To better understand how best to decrease inappropriate antibiotic prescribing for ARIs in telehealth, we are conducting a large randomized quality improvement trial testing both patient- and physician-facing feedback and behavioral nudges embedded in the electronic health record.

methodsTeladoc® clinicians are assigned to one of 9 arms in a 3 × 3 randomized trial. Each clinician is assigned to one of 3 Commitment groups (Public, Private, Control) and one of 3 Performance Feedback groups (Benchmark Peer Comparison, Trending, Control). After randomly selecting ⅓ of states and associated clinicians required for patient-facing components of the Public Commitment intervention, remaining clinicians are randomized to the Control and Private Commitment arms. Clinicians are randomized to the Performance Feedback conditions. The primary outcome is change from baseline in antibiotic prescribing rate for qualifying ARI visits. Secondary outcomes include changes in inappropriate prescribing and revisit rates. Secondary analyses include investigation of heterogeneity of treatment effects. With 1530 clinicians and an intra-clinician correlation in antibiotic prescribing rate of 0.5, we have >80% power to detect 1-7% absolute differences in antibiotic prescribing among groups. DISCUSSION: Findings from this trial may help inform telehealth stewardship strategies, determine whether significant differences exist between Commitment and Feedback interventions, and provide guidance for clinicians and patients to encourage safe and effective antibiotic use. CLINICALTRIALS: gov: NCT05138874.

Indexed as

Respiratory Tract InfectionsTelemedicineAnti-Bacterial AgentsElectronic Health RecordsHumansInappropriate PrescribingPractice Patterns, Physicians'Randomized Controlled Trials as TopicAnti-Bacterial AgentsAcute respiratory infectionAntibioticsAntibiotic stewardshipTelehealth

Identifiers

PMID35724841
PMCPMC13239793

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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.