The University of Southampton
University of Southampton Institutional Repository

An illness-focused interactive booklet to optimise management and medication for childhood fever and infections in out-of-hours primary care: study protocol for a cluster randomised trial

An illness-focused interactive booklet to optimise management and medication for childhood fever and infections in out-of-hours primary care: study protocol for a cluster randomised trial
An illness-focused interactive booklet to optimise management and medication for childhood fever and infections in out-of-hours primary care: study protocol for a cluster randomised trial
Background Fever is the most common reason for a child to be taken to a general practitioner (GP), especially during out-of-hours care. It is mostly caused by self-limiting infections. However, antibiotic prescription rates remain high, especially during out-of-hours care. Anxiety and lack of knowledge among parents, and perceived pressure to prescribe antibiotics amongst GPs, are important determinants of excessive antibiotic prescriptions. An illness-focused interactive booklet has the potential to improve this by providing parents with information about fever self-management strategies. The aim of this study is to develop and determine the effectiveness of an interactive booklet on management of children presenting with fever at Dutch GP out-of-hours cooperatives. Methods/design We are conducting a cluster randomised controlled trial (RCT) with 20 GP out-of-hours cooperatives randomised to 1 of 2 arms: GP access to the illness-focused interactive booklet or care as usual. GPs working at intervention sites will have access to the booklet, which was developed in a multistage process. It consists of a traffic light system for parents on how to respond to fever-related symptoms, as well as information on natural course of infections, benefits and harms of (antibiotic) medications, self-management strategies and ?safety net? instructions. Children <12 years of age with parent-reported or physician-measured fever are eligible for inclusion. The primary outcome is antibiotic prescribing during the initial consultation. Secondary outcomes are (intention to) (re)consult, antibiotic prescriptions during re-consultations, referrals, parental satisfaction and reassurance. In 6 months, 20,000 children will be recruited to find a difference in antibiotic prescribing rates of 25% in the control group and 19% in the intervention group. Statistical analysis will be performed using descriptive statistics and by fitting two-level (GP out-of-hours cooperative and patient) random intercept logistic regression models. Discussion This will be the first and largest cluster RCT evaluating the effectiveness of an illness-focused interactive booklet during GP out-of-hours consultations with febrile children receiving antibiotic prescriptions. It is hypothesised that use of the booklet will result in a reduced number of antibiotic prescriptions, improved parental satisfaction and reduced intention to re-consult.
1745-6215
1-10
Bont, Eefje G. P. M. de
5d2d1ae1-f78c-4773-8581-f374ea2a314e
Dinant, Geert-Jan
7d19eddd-8d85-4095-a68a-07e6babfb84e
Elshout, Gijs
cdd21e46-9d79-48c6-8794-a1012183dbe4
Well, Gijs van
820080a9-1da9-408e-b5c4-3e543138d4d7
Francis, Nicholas Andrew
9b610883-605c-4fee-871d-defaa86ccf8e
Winkens, Bjorn
b21f3400-82ef-44a5-880c-03ebf948a679
Cals, Jochen W. L.
ec7f8605-c306-4ce0-a833-a290c963c1cf
Bont, Eefje G. P. M. de
5d2d1ae1-f78c-4773-8581-f374ea2a314e
Dinant, Geert-Jan
7d19eddd-8d85-4095-a68a-07e6babfb84e
Elshout, Gijs
cdd21e46-9d79-48c6-8794-a1012183dbe4
Well, Gijs van
820080a9-1da9-408e-b5c4-3e543138d4d7
Francis, Nicholas Andrew
9b610883-605c-4fee-871d-defaa86ccf8e
Winkens, Bjorn
b21f3400-82ef-44a5-880c-03ebf948a679
Cals, Jochen W. L.
ec7f8605-c306-4ce0-a833-a290c963c1cf

Bont, Eefje G. P. M. de, Dinant, Geert-Jan, Elshout, Gijs, Well, Gijs van, Francis, Nicholas Andrew, Winkens, Bjorn and Cals, Jochen W. L. (2016) An illness-focused interactive booklet to optimise management and medication for childhood fever and infections in out-of-hours primary care: study protocol for a cluster randomised trial. Trials, 17 (1), 1-10, [547]. (doi:10.1186/s13063-016-1667-8).

Record type: Article

Abstract

Background Fever is the most common reason for a child to be taken to a general practitioner (GP), especially during out-of-hours care. It is mostly caused by self-limiting infections. However, antibiotic prescription rates remain high, especially during out-of-hours care. Anxiety and lack of knowledge among parents, and perceived pressure to prescribe antibiotics amongst GPs, are important determinants of excessive antibiotic prescriptions. An illness-focused interactive booklet has the potential to improve this by providing parents with information about fever self-management strategies. The aim of this study is to develop and determine the effectiveness of an interactive booklet on management of children presenting with fever at Dutch GP out-of-hours cooperatives. Methods/design We are conducting a cluster randomised controlled trial (RCT) with 20 GP out-of-hours cooperatives randomised to 1 of 2 arms: GP access to the illness-focused interactive booklet or care as usual. GPs working at intervention sites will have access to the booklet, which was developed in a multistage process. It consists of a traffic light system for parents on how to respond to fever-related symptoms, as well as information on natural course of infections, benefits and harms of (antibiotic) medications, self-management strategies and ?safety net? instructions. Children <12 years of age with parent-reported or physician-measured fever are eligible for inclusion. The primary outcome is antibiotic prescribing during the initial consultation. Secondary outcomes are (intention to) (re)consult, antibiotic prescriptions during re-consultations, referrals, parental satisfaction and reassurance. In 6 months, 20,000 children will be recruited to find a difference in antibiotic prescribing rates of 25% in the control group and 19% in the intervention group. Statistical analysis will be performed using descriptive statistics and by fitting two-level (GP out-of-hours cooperative and patient) random intercept logistic regression models. Discussion This will be the first and largest cluster RCT evaluating the effectiveness of an illness-focused interactive booklet during GP out-of-hours consultations with febrile children receiving antibiotic prescriptions. It is hypothesised that use of the booklet will result in a reduced number of antibiotic prescriptions, improved parental satisfaction and reduced intention to re-consult.

Full text not available from this repository.

More information

Published date: 17 November 2016

Identifiers

Local EPrints ID: 436084
URI: http://eprints.soton.ac.uk/id/eprint/436084
ISSN: 1745-6215
PURE UUID: 08ced321-2bb7-4d62-8f70-fffe80975bd1
ORCID for Nicholas Andrew Francis: ORCID iD orcid.org/0000-0001-8939-7312

Catalogue record

Date deposited: 27 Nov 2019 17:30
Last modified: 17 Dec 2019 01:20

Export record

Altmetrics

Contributors

Author: Eefje G. P. M. de Bont
Author: Geert-Jan Dinant
Author: Gijs Elshout
Author: Gijs van Well
Author: Bjorn Winkens
Author: Jochen W. L. Cals

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×