TY - JOUR
T1 - Feasibility of a randomised trial of a continuing medical education program in shared decision-making on the use of antibiotics for acute respiratory infections in primary care
T2 - The DECISION+ pilot trial
AU - LeBlanc, Annie
AU - Légaré, France
AU - Labrecque, Michel
AU - Godin, Gaston
AU - Thivierge, Robert
AU - Laurier, Claudine
AU - Côté, Luc
AU - O'Connor, Annette M.
AU - Rousseau, Michel
N1 - Funding Information:
This pilot study would not have been possible without the participation of physicians, nurses, patients, and office staff of the participating primary care practices, and therefore, we would like to gratefully acknowledge them. We would also like to acknowledge the work of S. Tapp, N. Allain-Boule, J. Rousseau, and S. St-Jacques. We thank G. Theriault for the revision of the manuscript. DECISION+ is funded by the Provincial Health Institution, le Fonds de la Recherche en Santé du Québec. F. Légaré holds a Tiers 2 Canada Research Chair on the implementation of shared decision-making in primary care practices. G. Godin holds a Tiers 1 Canada Research Chair on Behaviour and Health. A. LeBlanc holds a doctoral scholarship from the Canadian Institute of Health Research. A. O’Connor is a Tier 1 Canada Research Chair in Health Consumers Decision Support.
PY - 2011/1/18
Y1 - 2011/1/18
N2 - Background: The misuse and limited effectiveness of antibiotics for acute respiratory infections (ARIs) are well documented, and current approaches targeting physicians or patients to improve appropriate use have had limited effect. Shared decision-making could be a promising strategy to improve appropriate antibiotic use for ARIs, but very little is known about its implementation processes and outcomes in clinical settings. In this matter, pilot studies have played a key role in health science research over the past years in providing information for the planning, justification, and/or refinement of larger studies. The objective of our study was to assess the feasibility and acceptability of the study design, procedures, and intervention of the DECISION+ program, a continuing medical education program in shared decision-making among family physicians and their patients on the optimal use of antibiotics for treating ARIs in primary care.Methods: A pilot clustered randomised trial was conducted. Family medicine groups (FMGs) were randomly assigned, to either the DECISION+ program, which included three 3-hour workshops over a four- to six-month period, or a control group that had a delayed exposure to the program.Results: Among 21 FMGs contacted, 5 (24%) agreed to participate in the pilot study. A total of 39 family physicians (18 in the two experimental and 21 in the three control FMGs) and their 544 patients consulting for an ARI were recruited. The proportion of recruited family physicians who participated in all three workshops was 46% (50% for the experimental group and 43% for the control group), and the overall mean level of satisfaction regarding the workshops was 94%.Conclusions: This trial, while aiming to demonstrate the feasibility and acceptability of conducting a larger study, has identified important opportunities for improving the design of a definitive trial. This pilot trial is informative for researchers and clinicians interested in designing and/or conducting studies with FMGs regarding training of physicians in shared decision-making. Trial Registration: Clinicaltrials.Gov NCT00354315.
AB - Background: The misuse and limited effectiveness of antibiotics for acute respiratory infections (ARIs) are well documented, and current approaches targeting physicians or patients to improve appropriate use have had limited effect. Shared decision-making could be a promising strategy to improve appropriate antibiotic use for ARIs, but very little is known about its implementation processes and outcomes in clinical settings. In this matter, pilot studies have played a key role in health science research over the past years in providing information for the planning, justification, and/or refinement of larger studies. The objective of our study was to assess the feasibility and acceptability of the study design, procedures, and intervention of the DECISION+ program, a continuing medical education program in shared decision-making among family physicians and their patients on the optimal use of antibiotics for treating ARIs in primary care.Methods: A pilot clustered randomised trial was conducted. Family medicine groups (FMGs) were randomly assigned, to either the DECISION+ program, which included three 3-hour workshops over a four- to six-month period, or a control group that had a delayed exposure to the program.Results: Among 21 FMGs contacted, 5 (24%) agreed to participate in the pilot study. A total of 39 family physicians (18 in the two experimental and 21 in the three control FMGs) and their 544 patients consulting for an ARI were recruited. The proportion of recruited family physicians who participated in all three workshops was 46% (50% for the experimental group and 43% for the control group), and the overall mean level of satisfaction regarding the workshops was 94%.Conclusions: This trial, while aiming to demonstrate the feasibility and acceptability of conducting a larger study, has identified important opportunities for improving the design of a definitive trial. This pilot trial is informative for researchers and clinicians interested in designing and/or conducting studies with FMGs regarding training of physicians in shared decision-making. Trial Registration: Clinicaltrials.Gov NCT00354315.
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U2 - 10.1186/1748-5908-6-5
DO - 10.1186/1748-5908-6-5
M3 - Article
C2 - 21241514
AN - SCOPUS:78751596585
SN - 1748-5908
VL - 6
JO - Implementation Science
JF - Implementation Science
IS - 1
M1 - 5
ER -