An interventional study of Education and feedback and Clinical decision support in Community-acquired Pneumonia and Skin Infection, sponsored by Boston Children's Hospital. Completed at 1 site in United States. Per ClinicalTrials.gov, last updated 2023-10-18.
Sponsored by Boston Children's Hospital · Not applicable, Interventional, and Treatment
Randomized quality improvement trial to improve the proportion of cases of community-acquired pneumonia (CAP) treated with no more than 5 days of antibiotics the proportion of cases of skin and soft tissue infections (SSTI) treated with no more than 7 days of antibiotics by primary care clinicians (PCC) within the Pediatric Physicians' Organization at Children's (PPOC), a state-wide pediatric primary care network. Interventions include education and feedback; clinical decision support (CDS) delivered at the point of care; and the combination of the two.
90 studies on the registry are indexed under Community-Acquired Pneumonia; 53 are open to participants now.
This study's enrollment of 75 is below the median of 297 across 58 interventional studies indexed under Community-Acquired Pneumonia.
Browse Community-Acquired Pneumonia studies →Boston Children's Hospital is the lead sponsor of 607 studies on the registry; 148 are open to participants now.
Of its 33 completed or terminated interventional studies of FDA-regulated products, 19 (58%) have results posted.
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EXCLUSION CRITERIA
-None
No intervention
Clinicians within practices assigned to the Education/Feedback group received a personal email from one of the authors at the outset of the project explaining that the Committee on Infectious Diseases of the American Academy of Pediatrics (the "Red Book Committee") recommends limiting the duration of antibiotic treatment for uncomplicated CAP to 5 days and for uncomplicated SSTI to 5-7 days. The email also shared data on the performance of the individual PCC and their practice for CAP and SSTI for the baseline period and the goals for each-50% for CAP and 67% for SST. An infographic was also attached to the email which could be printed and displayed in the PCC's work area. One month and two months into the project period, each PCC in the Education/Feedback group received an email reminding them of the recommendations and updating them on their performance since the previous email.
Behavioral: Education and feedback
Clinicians within practices assigned to the CDS group did not receive education or any performance feedback relative to the initiative. If they prescribed an antibiotic linked to a diagnosis of CAP with a duration of greater than 5 days, or to a diagnosis of SSTI with a duration greater than 7 days, they received a pop-up advisory when they attempted to sign the prescription alerting them to the relevant recommendation (eFigure 3). The alert was a "hard stop", meaning that the prescriber was required to respond in some way to continue their work. Options included altering the prescription to comply with the recommended duration or acknowledging the alert and sending the prescription with the originally selected duration.
Behavioral: Clinical decision support
Clinicians within practices assigned to the combined group received both interventions as described above.
Behavioral: Education and feedback · Behavioral: Clinical decision support
Clinicians within practices assigned to the Education/Feedback group received a personal email from one of the authors at the outset of the project explaining that the Committee on Infectious Diseases of the American Academy of Pediatrics (the "Red Book Committee") recommends limiting the duration of antibiotic treatment for uncomplicated CAP to 5 days and for uncomplicated SSTI to 5-7 days. The email also shared data on the performance of the individual PCC and their practice for CAP and SSTI for the baseline period and the goals for each-50% for CAP and 67% for SST. An infographic was also attached to the email which could be printed and displayed in the PCC's work area. One month and two months into the project period, each PCC in the Education/Feedback group received an email reminding them of the recommendations and updating them on their performance since the previous email.
Clinicians within practices assigned to the CDS group did not receive education or any performance feedback relative to the initiative. If they prescribed an antibiotic linked to a diagnosis of CAP with a duration of greater than 5 days, or to a diagnosis of SSTI with a duration greater than 7 days, they received a pop-up advisory when they attempted to sign the prescription alerting them to the relevant recommendation (eFigure 3). The alert was a "hard stop", meaning that the prescriber was required to respond in some way to continue their work. Options included altering the prescription to comply with the recommended duration or acknowledging the alert and sending the prescription with the originally selected duration.
Proportion of cases of CAP and SSTI treated with short course antibiotic treatment
Proportion of cases of CAP and SSTI treated with short course antibiotic treatment (\<=5 days for CAP, \<=7 days for SSTI)
Time frame: 3 months
Proportion of cases of CAP treated with short course antibiotic treatment
Proportion of cases of CAP treated with short course antibiotic treatment (\<=5 days)
Time frame: 3 months
Proportion of cases of SSTI treated with short course antibiotic treatment
Proportion of cases of SSTI treated with short course antibiotic treatment (\<=7 days)
Time frame: 3 months
Plan to share: No
Ran from Feb 2023 to primary completion in May 2023, 2 months.
Of 20 interventional studies with no phase under Community-Acquired Pneumonia, half reached primary completion within 30 months of starting (the median), counting those still running; a quarter within 20 and three quarters within 59. This study's 2 months is below that.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in Oct 2023. You cannot join it, but the record below documents what was studied.
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Community-Acquired Pneumonia →