scholarly journals Electronic Health Records for Intervention Research: A Cluster Randomized Trial to Reduce Antibiotic Prescribing in Primary Care (eCRT Study)

2014 ◽  
Vol 12 (4) ◽  
pp. 344-351 ◽  
Author(s):  
M. C. Gulliford ◽  
T. van Staa ◽  
A. Dregan ◽  
L. McDermott ◽  
G. McCann ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Records ◽  
Randomized Trial ◽  
Cluster Randomized Trial ◽  
Intervention Research ◽  
Antibiotic Prescribing ◽  
Health Records ◽  
Electronic Health ◽  
Cluster Randomized

scholarly journals Point-of-Care Cluster Randomized Trial in Stroke Secondary Prevention Using Electronic Health Records

Stroke ◽  
2014 ◽  
Vol 45 (7) ◽  
pp. 2066-2071 ◽  
Author(s):  
Alex Dregan ◽  
Tjeerd P. van Staa ◽  
Lisa McDermott ◽  
Gerard McCann ◽  
Mark Ashworth ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Secondary Prevention ◽  
Randomized Trial ◽  
Point Of Care ◽  
Cluster Randomized Trial ◽  
Health Records ◽  
Electronic Health ◽  
Cluster Randomized

scholarly journals Assessing Reduction of Antibiotic Prescribing for Acute, Non-complicated Infections in Primary Care in Germany: Multi-step Outcome Evaluation in the Cluster-Randomized Trial ARena

2021 ◽  
Author(s):  
Regina Poss-Doering ◽  
Dorothea Kronsteiner ◽  
Martina Kamradt ◽  
Petra Kaufmann-Kolle ◽  
Edith Andres ◽  
...  
Keyword(s):  
Primary Care ◽  
Randomized Trial ◽  
Primary Care Physicians ◽  
Standard Care ◽  
Cluster Randomized Trial ◽  
Outcome Evaluation ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Implementation Program ◽  
Cluster Randomized

The three-armed cluster-randomized trial ARena (Sustainable reduction of antibiotic-induced antimicrobial resistance) aimed to foster appropriate antibiotic use and reduce overprescribing in German ambulatory care to counter antibiotic resistance. Multi-faceted interventions targeted primary care physicians, teams and patients. This study examined effectiveness of the implementation program. ARena was conducted in 14 primary care networks with 196 practices. All arms received data-based feedback on antibiotics prescribing and quality circles. Arms II and III received different add-on components each. Primary outcome examined is the prescribing rate for systemic antibiotics for cases with non-complicated acute infections (upper respiratory tract, bronchitis, sinusitis, tonsillitis, otitis media). Secondary outcomes refer to prescribing of quinolones and guideline-recommended antibiotics. Based on pseudonymized quarterly claims data, mixed logistic regression models examined pre-post intervention antibiotic prescribing rate changes and compared to matched standard care. A significant rate reduction (arm I 11.7%; arm II 9.9%; arm III 12.7%) and significantly lower prescribing rates were observed for all arms (20.1%, 18.9% and 23.6%) compared to matched standard care (29.4%). Fluoroquinolone prescribing was reduced in all intervention arms and rates for recommended substances generally increased. No significant post-interventional difference between intervention arms was detected. Findings indicate implementation program impact compared to standard care. Trial registration: ISRCTN, ISRCTN58150046

scholarly journals Assessing Reduction of Antibiotic Prescribing for Acute, Non-Complicated Infections in Primary Care in Germany: Multi-Step Outcome Evaluation in the Cluster-Randomized Trial ARena

Antibiotics ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1151
Author(s):  
Regina Poss-Doering ◽  
Dorothea Kronsteiner ◽  
Martina Kamradt ◽  
Petra Kaufmann-Kolle ◽  
Edith Andres ◽  
...  
Keyword(s):  
Primary Care ◽  
Randomized Trial ◽  
Primary Care Physicians ◽  
Standard Care ◽  
Cluster Randomized Trial ◽  
Outcome Evaluation ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Implementation Program ◽  
Cluster Randomized

The three-armed cluster-randomized trial ARena (sustainable reduction of antibiotic-induced antimicrobial resistance) aimed to foster appropriate antibiotic use and reduce overprescribing in German ambulatory care to counter antibiotic resistance. Multi-faceted interventions targeted primary care physicians, teams and patients. This study examined the effectiveness of the implementation program. ARena was conducted in 14 primary care networks with 196 practices. All arms received data-based feedback on antibiotics prescribing and quality circles. Arms II and III received different add-on components each. Primary outcome examined is the prescribing rate for systemic antibiotics for cases with non-complicated acute infections (upper respiratory tract, bronchitis, sinusitis, tonsillitis, otitis media). Secondary outcomes refer to the prescribing of quinolones and guideline-recommended antibiotics. Based on pseudonymized quarterly claims data, mixed logistic regression models examined pre-post intervention antibiotic prescribing rate changes and compared to matched standard care. A significant rate reduction (arm I 11.7%; arm II 9.9%; arm III 12.7%) and significantly lower prescribing rates were observed for all arms (20.1%, 18.9% and 23.6%) compared to matched standard care (29.4%). Fluoroquinolone prescribing was reduced in all intervention arms and rates for recommended substances generally increased. No significant post-interventional difference between intervention arms was detected. Findings indicate implementation program impact compared to standard care.

scholarly journals Design of a cluster-randomized trial of electronic health record-based tools to address overweight and obesity in primary care

2015 ◽  
Vol 12 (4) ◽  
pp. 374-383 ◽  
Author(s):  
Heather J Baer ◽  
Christina C Wee ◽  
Katerina DeVito ◽  
E John Orav ◽  
Joseph P Frolkis ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Record ◽  
Randomized Trial ◽  
Cluster Randomized Trial ◽  
Overweight And Obesity ◽  
Health Record ◽  
Electronic Health ◽  
Cluster Randomized

scholarly journals Antibiotic prescribing frequency amongst patients in primary care: a cohort study using electronic health records

2017 ◽  
Vol 72 (6) ◽  
pp. 1818-1824 ◽  
Author(s):  
Laura Shallcross ◽  
Nick Beckley ◽  
Greta Rait ◽  
Andrew Hayward ◽  
Irene Petersen
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Electronic Health Records ◽  
Antibiotic Prescribing ◽  
Health Records ◽  
Electronic Health

Preliminary results from the COPE study using primary-care electronic health records and environmental modelling to examine COPD exacerbations

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696749 ◽  
Author(s):  
Maimoona Hashmi ◽  
Mark Wright ◽  
Kirin Sultana ◽  
Benjamin Barratt ◽  
Lia Chatzidiakou ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Records ◽  
Health Management ◽  
Practice Research ◽  
Chronic Obstructive ◽  
Clinical Practice Research Datalink ◽  
Health Records ◽  
Preliminary Results ◽  
Copd Exacerbations ◽  
Electronic Health

BackgroundChronic Obstructive Airway Disease (COPD) is marked by often severely debilitating exacerbations. Efficient patient-centric research approaches are needed to better inform health management primary-care.AimThe ‘COPE study’ aims to develop a method of predicting COPD exacerbations utilising personal air quality sensors, environmental exposure modelling and electronic health records through the recruitment of patients from consenting GPs contributing to the Clinical Practice Research Datalink (CPRD).MethodThe study made use of Electronic Healthcare Records (EHR) from CPRD, an anonymised GP records database to screen and locate patients within GP practices in Central London. Personal air monitors were used to capture data on individual activities and environmental exposures. Output from the monitors were then linked with the EHR data to obtain information on COPD management, severity, comorbidities and exacerbations. Symptom changes not equating to full exacerbations were captured on diary cards. Linear regression was used to investigate the relationship between subject peak flow, symptoms, exacerbation events and exposure data.ResultsPreliminary results on the first 80 patients who have completed the study indicate variable susceptibility to environmental stressors in COPD patients. Some individuals appear highly susceptible to environmental stress and others appear to have unrelated triggers.ConclusionRecruiting patients through EHR for a study is feasible and allows easy collection of data for long term follow up. Portable environmental sensors could now be used to develop personalised models to predict risk of COPD exacerbations in susceptible individuals. Identification of direct links between participant health and activities would allow improved health management thus cost savings.

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