Evidence map›Paper›PMID 37984980›Full record

ArticleBJGP open2024

The DAWN antivirals trial: process evaluation of a COVID-19 trial in general practice.

Dajana Tare, Samuel Coenen, An De Sutter, Stefan Heytens, Dirk Devroey, Laetitia Buret, Birgitte Schoenmakers, Nicolas Delvaux, Jan Y Verbakel, Kris Bogaerts and 1 more

Abstract read
In one paragraph

Article in BJGP open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the 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.

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

1 citing paper in PubMed.

  1. Review
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

11 authors.

Dajana TareAcademic Centre for General Practice, KU Leuven, Belgium.
Samuel CoenenCentre for General Practice, Department of Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerpen, Belgium.ORCID https://orcid.org/0000-0002-1238-8052
An De SutterDepartment of Public Health and Primary Care, Ghent University, KU Leuven, Belgium.
Stefan HeytensDepartment of Public Health and Primary Care, Ghent University, KU Leuven, Belgium.
Dirk DevroeyPrimary Care, Vrije Universiteit Brussel, Ixelles, Belgium.
Laetitia BuretDepartment of General Medicine, University of Liège, Liège, Belgium.
Birgitte SchoenmakersAcademic Centre for General Practice, KU Leuven, Belgium.ORCID https://orcid.org/0000-0003-1909-9613
Nicolas DelvauxAcademic Centre for General Practice, KU Leuven, Belgium.
Jan Y VerbakelAcademic Centre for General Practice, KU Leuven, Belgium.ORCID https://orcid.org/0000-0002-7166-7211
Kris BogaertsDepartment of Public Health and Primary Care, I-BioStat, KU Leuven, Leuven, Belgium.
Ann van den BruelAcademic Centre for General Practice, KU Leuven, Belgium ann.vandenbruel@kuleuven.be.ORCID https://orcid.org/0000-0001-9012-2009

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe DAWN antivirals trial was a multicentric, randomised placebo-controlled trial evaluating antiviral medication for COVID-19 in general practice. The trial was prematurely terminated because of insufficient recruitment.

aimTo explore which factors contributed to the premature termination. DESIGN &

settingGeneral practice in Belgium.

methodPatients were randomised to camostat or placebo (patients and physicians blinded) between June 2021 and July 2022; a third arm evaluating molnupiravir (open label) was opened in March 2022. The outcome assessor was blinded for all comparisons except for the patient reported outcomes in case of molnupiravir. The authors analysed available trial data and evaluated trial context, implementation, and mechanisms of impact based on semi-structured interviews with trial stakeholders.

resultsThe trial recruited 44 participants; 19 were allocated to camostat (median age 55 years), 8 to molnupiravir (median age 60 years), and 17 to placebo (median age 56 years). There were no serious adverse events in either group. Most difficulties were related to the pandemic context: disruption to routine clinical services; multiple changes to the service model for COVID-19 patients; overwhelmed clinical staff; delays of trial medication; and staff shortages in the sponsor and clinical team. In addition, regulatory approval processes were lengthy and led to additional study procedures. It was felt that the trial started too late, when vaccinations had already begun.

conclusionThe DAWN antivirals trial was stopped prematurely. Although many barriers were related to the pandemic itself, hurdles such as a small and inexperienced sponsor and clinical teams, delays in regulatory processes, and research capacity in routine settings could be overcome by established research infrastructure and standardisation of processes.

Indexed as

antiviralCOVID-19primary healthcarerandomized controlled trial

Identifiers

PMID37984980
PMCPMC11300998

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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.