An interventional study of Feedback on RTD metric in Antibacterial Agents and Ambulatory Care, sponsored by Daniel Livorsi. Active, not recruiting at 1 site in United States. Open to participants aged 21 Years to 99 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-12-24.
Sponsored by Daniel Livorsi · Not applicable, Interventional, and Health services research
Many clinicians prescribe antibiotics for patients with acute respiratory infections even when antibiotics will not benefit the patient because the infection is due to a virus. To discourage this type of unnecessary antibiotic use, the investigators will assess whether it is helpful to give clinicians feedback on how often they prescribe antibiotics for respiratory infections in comparison to their peers. The investigators will perform this study across Urgent Care and QuickCare clinics within a single healthcare system.
The investigators have used an established HEDIS (Healthcare Effectiveness Data and Information Set) metric to evaluate Urgent Care and QuickCare clinicians on their antibiotic use for respiratory tract diagnoses (RTDs). This RTD metric excludes visits that are more complicated, based on well-defined criteria. Based on our baseline assessment (2018-2022), the investigators estimate that most clinicians in this setting are frequently prescribing unnecessary antibiotics.
The investigators will perform a randomized controlled trial to assess whether providing individualized feedback to clinicians on the RTD metric can safely reduce antibiotic use for qualifying respiratory tract visits across Urgent and QuickCare settings within a single integrated healthcare system. Clinicians who do not opt-out of the trial will be randomized to either receive feedback or not receive feedback on this RTD metric. The trial will last for 18 months. The primary outcome of effectiveness will be the frequency of antibiotic-prescribing for RTD visits. Secondary outcomes include total antibiotic use (regardless of diagnosis), changes in the use of diagnostic codes, 30-day rates of follow-up visits and hospital admissions. The RE-AIM framework will be used to guide additional study evaluation.
This is the only study on the registry with Daniel Livorsi as lead sponsor.
Counted across the registry records on this site, refreshed daily.
Any clinician who works in Urgent Care or QuickCare clinics within our healthcare system.
An e-mail will be sent to the clinicians in the experimental arm every two months describing their performance on the RTD metric and making a comparison to how their peers have performed. The e-mail will also direct clinicians to visit a dashboard to review their practice in greater depth.
Behavioral: Feedback on RTD metric
Any clinician assigned to the control arm will not receive the above-mentioned e-mails.
Clinicians in the experimental arm will receive feedback on the RTD metric while clinicians in the No intervention arm will not.
Frequency of antibiotic-prescribing for RTD visits
Percentage of all qualifying respiratory tract diagnosis (RTD) visits prescribed an antibiotic
Time frame: 24 hours of visit
Frequency of antibiotic-prescribing for all visits
Percentage of all visits prescribed an antibiotic, regardless of the diagnosis
Time frame: 24 hours of visit
Follow-up visit to Urgent Care or QuickCare
Percentage of patients with a qualifying RTD visit who were seen at least once in Urgent Care or QuickCare within the 30 days after their index visit date.
Time frame: 30 days
Follow-up Emergency Department visit and/or acute-care hospitalization
Percentage of patients with a qualifying RTD visit who were seen at least once in the Emergency Department and/or who were hospitalized (any reason) within the 30 days after their index visit date.
Time frame: 30 days
Documents are hosted by the registry — open the source record to download them.
Plan to share: No
This study is active, not recruiting, as verified in Dec 2025. You cannot join it, but the record below documents what was studied.
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