Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands.
BMJ Open. 2021 Oct 11;11(10):e054674. doi: 10.1136/bmjopen-2021-054674.
Although antibiotic use and antimicrobial resistance in the Netherlands is comparatively low, inappropriate prescription of antibiotics is substantial, mainly for respiratory tract infections (RTIs). General practitioners (GPs) experience pressure from patients with an immigration background to prescribe antibiotics and have difficulty communicating in a culturally sensitive way. Multifaceted interventions including communication skills training for GPs are shown to be most effective in reducing antibiotic prescription. The PARCA study aims to reduce the number of antibiotic prescriptions for RTIs through implementing a culturally sensitive communication intervention for GPs and evaluate it in a randomised controlled trial (RCT).
A non-blinded RCT including 58 GPs (29 for each arm). The intervention consists of: (1) An E-learning with 4 modules of 10-15 min each; (2) A face-to-face training session in (intercultural) communication skills including role plays with a training actor and (3) Availability of informative patient-facing materials that use simple words (A2/B1 level) in multiple languages. The primary outcome measure is the number of dispensed antibiotic courses qualifying for RTIs in primary care, per 1000 registered patients. The secondary outcome measure is the number of all dispensed antibiotic courses, per 1000 registered patients. The intervention arm will receive the training in Autumn 2021, followed by an observation period of 6 winter months for which numbers of antibiotics will be collected for both trial arms. The GPs/practices in the control arm can attend the training after the observation period.
The study protocol was approved by the Medical Ethics Review Committee of Erasmus MC, University Medical Center Rotterdam (MEC-2020-0142). The results of the trial will be published in international peer-reviewed scientific journals and will be disseminated through national and international congresses. The project is funded by The Netherlands Organisation for Health Research and Development (ZonMw).
NL9450.
尽管荷兰的抗生素使用和抗菌药物耐药情况相对较低，但抗生素的不当处方仍然大量存在，主要是用于治疗呼吸道感染（RTIs）。有移民背景的患者向全科医生（GPs）施压要求开抗生素，这给他们造成了压力，使他们难以以文化敏感的方式进行沟通。多项干预措施，包括对全科医生进行沟通技巧培训，已被证明可有效减少抗生素处方。PARCA 研究旨在通过实施针对全科医生的文化敏感沟通干预措施来减少 RTIs 的抗生素处方数量，并通过随机对照试验（RCT）对其进行评估。
一项非盲 RCT，纳入了 58 名全科医生（每组 29 名）。该干预措施包括：（1）包含 4 个模块（每个模块 10-15 分钟）的电子学习课程；（2）面对面的沟通技巧培训课程，包括与培训演员进行角色扮演；（3）提供使用简单词汇（A2/B1 级）的多种语言的患者信息材料。主要结局指标是每 1000 名注册患者中符合 RTIs 标准的抗生素处方数量。次要结局指标是每 1000 名注册患者中开出的所有抗生素处方数量。干预组将于 2021 年秋季接受培训，随后进行 6 个月的冬季观察期，在此期间将为试验组和对照组收集抗生素处方数量。对照组的全科医生/诊所可以在观察期结束后参加培训。
该研究方案已获得鹿特丹伊拉斯谟医学中心（Erasmus MC）医学伦理审查委员会的批准（MEC-2020-0142）。试验结果将发表在国际同行评议的科学期刊上，并通过国内外会议进行传播。该项目由荷兰健康研究与发展组织（ZonMw）资助。
NL9450。
