Brief verbal intervention to address inappropriate prescriptions of chinese patent medicines among western practitioners in primary health care (BRAVERY): a study protocol for an unannounced standardized patient experiment with a factorial design randomized controlled trial in China.

introductionChinese patent medicines, produced using advanced pharmaceutical techniques and available in various forms, including powders, granules, tablets, pills, and capsules, finds extensive utilization among Western medicine practitioners in primary healthcare (WMP-PHC). However, the inappropriate overprescribing of these medicines has led to significant resource waste and raised considerable concerns. Therefore, we aim to address related knowledge gaps by employing unannounced standardized patients (USPs) as a method, for both measurement and intervention research. Specifically, in this paper, we present a study protocol that aims to develop and evaluate the effectiveness of brief verbal interventions (BVI) delivered by USPs, with the objective of improving the appropriate prescription of Chinese patent medicines. The study aims to equip patients with simple and easily implementable interventions to enhance the appropriate prescription of Chinese patent medicines. Furthermore, The findings from this study will provide valuable insights for policymakers, enabling them to comprehend the current levels of inappropriate Chinese patent medicines prescription and develop targeted policy interventions. METHODS AND ANALYSIS: We will record a total of 576 encounters in primary healthcare (PHC) facilities across two cities in China. The data will be randomized using a 2 × 2 × 2 × 2 factorial design randomized controlled trial (RCT), which includes factors such as financial incentives, knowledge and skills, prescribing habits, and patient expectation. USPs will collect data, including retrieving prescriptions and documenting the process of medical encounters. The primary outcome evaluation focuses on the appropriateness of Chinese patent medicines prescriptions. Secondary outcomes include the quality of the consultation process, patient satisfaction, cost information, service time, and appropriateness of antibiotic prescriptions. Descriptive analysis will be performed for the survey results, and the difference in outcomes between interventions and control providers will be compared and statistically tested using generalized linear mixed model (GLMM). TRIAL REGISTRATION NUMBER: The study has been registered at the China Clinical Trials Registry (ChiCTR2300077913) on 23 November 2023.