Acute Respiratory Infections (ARIs)BEARINCT01454947

Use of Behavioral Economics to Improve Treatment of Acute Respiratory Infections (Main Study)

A study testing Clinical Decision Support (CDS): Accountable Justifications, Audit and Feedback: Peer Comparison and CDS Order Sets: Suggested Alternatives in people with Acute Respiratory Infections (ARIs), run by University of Southern California at 55 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record

Search all trials

Trial summary

Who is it for?: Ages 18 years and older
Conditions the study is for: Acute Respiratory Infections (ARIs)
What is being tested?: Clinical Decision Support (CDS): Accountable Justifications, Audit and Feedback: Peer Comparison and CDS Order Sets: Suggested Alternatives
Type of treatment: Lifestyle or therapy programme
Could I receive a placebo?: No, everyone receives an active treatment
How many people: 248 participants
Where: 55 sitesUnited States
Study dates: Aug 2011to Sep 2014
Phase: Interventional
Are there results?: Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

Ages 18 years and older
All sexes
No healthy volunteers
Adult, Older adult

Who may be able to join

A practicing attending physician or advanced practice nurse ("provider") at a participating clinic in 2011-2013 who sees acute respiratory infection patients.

Who cannot join

None.

Trial locations and contacts

55 sites in 1 country.

City, postcode or hospital

55 sites in 1 country

United States55 sites

Altamed Anaheim Lincoln
Anaheim, California, 92801
Altamed Anaheim West
Anaheim, California, 92801
Altamed Bell Clinic
Bell, California, 90201
Brigham and Women's Primary Care Associates at Foxborough
Boston, Massachusetts, 02035
MGH Downtown
Boston, Massachusetts, 02108
Mass General Medial Group
Boston, Massachusetts, 02114
MGH Beacon Hill
Boston, Massachusetts, 02114
MGH Senior Health
Boston, Massachusetts, 02114
Women's Health Associates
Boston, Massachusetts, 02114
Brigham Circle Medical Associates
Boston, Massachusetts, 02115
Brigham Internal Medicine Associates
Boston, Massachusetts, 02115
Spanish Clinic
Boston, Massachusetts, 02115
MGH Back Bay
Boston, Massachusetts, 02228
Brigham and Women's Primary Care Associates of Brookline
Brookline, Massachusetts, 02446
MGH Charlestown HealthCare Center
Charlestown, Massachusetts, 02129
MGH Chelsea HealthCare Center
Chelsea, Massachusetts, 02150
Brigham and Women's Physician Group
Chestnut Hill, Massachusetts, 02467
Gretchen and Edward Fish Center for Women's Health
Chestnut Hill, Massachusetts, 02467
Altamed Mobile Unit Primary Care
Commerce, California, 90040
Altamed DVL El Monte
El Monte, California, 91731
Altamed El Monte Clinic
El Monte, California, 91731
Everett Family Practice
Everett, Massachusetts, 02149
Altamed Garden Grove Harbor
Garden Grove, California, 92840
Altamed Huntington Beach Clinic
Huntington Beach, California, 92647
Altamed PACE Rugby
Huntington Park, California, 90255
Brigham Primary Physicians at Faulkner
Jamaica Plain, Massachusetts, 02130
Brookside Community Health Center
Jamaica Plain, Massachusetts, 02130
Faulkner Community Physicians
Jamaica Plain, Massachusetts, 02130
Southern Jamaica Plain Health Center
Jamaica Plain, Massachusetts, 02130
The Children's Clinic Family Health Center at Cesar Chavez Elementary School
Long Beach, California, 90802
The Children's Clinic Family Health Center at Hamilton Middle School
Long Beach, California, 90805
The S. Mark Taper Foundation Children's Clinic Family Health Center
Long Beach, California, 90806
The Children's Clinic at the Long Beach Multi-Service Center for the Homeless
Long Beach, California, 90813
The Vasek Polak Children's Clinic Family Health Center
Long Beach, California, 90813
Altamed PACE Grand Plaza
Los Angeles, California, 90012
Altamed William Mead Homes
Los Angeles, California, 90012
Altamed Commerce Clinic
Los Angeles, California, 90022
Altamed DVL Commerce
Los Angeles, California, 90022
Altamed PACE Pomona
Los Angeles, California, 90022
Altamed Boyle Heights Clinic
Los Angeles, California, 90023
Altamed Estrada Courts
Los Angeles, California, 90023
Altamed Ramona Gardens
Los Angeles, California, 90023
AltaMed 1st St Boyle Heights Clinic
Los Angeles, California, 90033
Altamed Zonal Clinic
Los Angeles, California, 90033
Altamed Montebello Clinic
Montebello, California, 90640
Brigham and Women's Primary Care Associates of Newton Corner
Newton, Massachusetts, 02458
Altamed El Modena Clinic
Orange, California, 92869
Altamed Pico Clinic
Pico Rivera, California, 90060
Altamed DVL Pico
Pico Rivera, California, 90660
Mass General Revere HealthCare Center
Revere, Massachusetts, 02151
Altamed Santa Ana Main
Santa Ana, California, 92701
Altamed Clinic For Women
Santa Ana, California, 92706
Altamed Santa Ana Broadway
Santa Ana, California, 92707
Altamed Santa Ana Central
Santa Ana, California, 92707
Mass General West Medical Group
Waltham, Massachusetts, 02451

Other trials in United States

About this study

Bacteria resistant to antibiotic therapy are a major public health problem. The evolution of multi-drug resistant pathogens may be encouraged by provider prescribing behavior. Inappropriate use of antibiotics for nonbacterial infections and overuse of broad spectrum antibiotics can lead to the development of resistant strains. Though providers are adequately trained to know when antibiotics are and are not comparatively effective, this has not been sufficient to affect critical provider practices.

The intent of this study is to apply behavioral economic theory to reduce the rate of antibiotic prescriptions for acute respiratory diagnoses for which guidelines do not call for antibiotics. Specifically targeted are infections that are likely to be viral.

The objective of this study is to improve provider decisions around treatment of acute respiratory infections.

The participants are practicing attending physicians or advanced practice nurses (i.e. providers) at participating clinics who see acute respiratory infection patients. A maximum of 550 participants will be recruited for this study.

Providers consenting to participate will fill out a baseline questionnaire online. Subsequent to baseline data collection and enrollment, participating clinic sites will be randomized to the study arms, as described below.

There will be a control arm, with clinic sites randomized in a multifactorial design to up to three interventions that leverage the electronic medical record: Order Sets that are triggered by electronic health record (EHR) workflow containing exclusively guideline concordant choices (SA, for Suggested Alternatives); Accountable Justifications triggered by discordant prescriptions that populate the note with provider's rationale for guideline exceptions (AJ); and performance feedback that benchmarks providers' own performance to that of their peers (PC, for Peer Comparisons).

The outcomes of interest are antibiotic prescribing patterns, including prescribing rates and changes in prescribing rates over time.

The intervention period will be over one year, with a one-year follow up period to measure persistence of the effect after EHR features are returned to the original state and providers no longer receive email alerts.

Read the detailed description

Each consented provider will be randomized to 1 of 8 cells in a factorial design with equal probability. If results of retrospective data analysis imply that design will be improved by stratification, randomization will be stratified by factors that could influence outcomes.

Data will be collected from the clinics' Enterprise Data Warehouses which store copies of data recorded in the electronic health record. Data elements from qualifying office visits will be collected from coded portions of the electronic health record.

An encounter is eligible for intervention if the patient's diagnosis is in the selected group of acute respiratory infections. The intervention EHR functions will be triggered when clinicians initiate an antibiotic prescription or enter a diagnosis for an acute respiratory infection that has a defined Order Set. If an antibiotic from a list of frequently misprescribed antibiotics is ordered and a diagnosis has not yet been entered, providers will be prompted to enter a diagnosis. If the diagnosis entered is acute nasopharyngitis; acute laryngopharyngitis/acute upper respiratory infection; acute bronchitis; bronchitis not specified as acute or chronic; or flu; the interventions will be triggered. The diagnosis-appropriate order set will pop-up for providers in the SA arm, while clinicians randomized to the AJ arm will receive an alert and be required to enter a brief statement justifying their antibiotic prescription if antibiotics are not indicated for the diagnosis entered. This note will then be added to the patient's medical record.

Clinicians randomized to the Peer Comparison condition will receive email updates about their antibiotic prescribing practices relative to other clinicians in their practice.

Conditions: Acute Respiratory Infections (ARIs)
Being tested: Clinical Decision Support (CDS): Accountable Justifications, Audit and Feedback: Peer Comparison, CDS Order Sets: Suggested Alternatives
Keywords: Antibiotics, Inappropriate Prescribing, Respiratory Tract Infections, Behavioral Research
Medical subject headings: Respiratory Tract Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Clinical Decision Support (CDS): Accountable JustificationsBehavioural
Also called AJ, Accountable Justification
Accountable Justifications triggered by discordant prescriptions that populate the electronic health record (EHR) note with provider's rationale for guideline exceptions (AJ).
Audit and Feedback: Peer ComparisonBehavioural
Also called PC, Peer Comparison
Performance feedback that benchmarks providers' own performance to that of their peers (PC, for Peer Comparison).
CDS Order Sets: Suggested AlternativesBehavioural
Also called SA, Suggested Alternatives
Order Sets that are triggered by EHR workflow containing exclusively guideline concordant choices (SA, for Suggested Alternatives).

Study groups in NCT01454947
Study group	Role	What they receive
SA, AJ, PC	Experimental	Participants are given all 3 interventions. Receives: Behavioral: Clinical Decision Support (CDS): Accountable Justifications; Behavioral: Audit and Feedback: Peer Comparison; Behavioral: CDS Order Sets: Suggested Alternatives
SA, AJ	Experimental	Participants receive the Suggested Alternatives and Accountable Justification interventions, but not the Peer Comparison intervention. Receives: Behavioral: Clinical Decision Support (CDS): Accountable Justifications; Behavioral: CDS Order Sets: Suggested Alternatives
SA, PC	Experimental	Participants receive the Suggested Alternative and Peer Comparison interventions, but not the Accountable Justification intervention. Receives: Behavioral: Audit and Feedback: Peer Comparison; Behavioral: CDS Order Sets: Suggested Alternatives
AJ, PC	Experimental	Participants receive the Accountable Justification and Peer Comparison interventions, but not the Suggested Alternative intervention. Receives: Behavioral: Clinical Decision Support (CDS): Accountable Justifications; Behavioral: Audit and Feedback: Peer Comparison
Peer Comparison (PC)	Experimental	Participants receive the Peer Comparison intervention, but do not receive the Suggested Alternatives or Accountable Justification interventions. Receives: Behavioral: Audit and Feedback: Peer Comparison
Suggested Alternatives (SA)	Experimental	Participants receive the Suggested Alternatives intervention, but not the Accountable Justification or Peer Comparison interventions. Receives: Behavioral: CDS Order Sets: Suggested Alternatives
Accountable Justification (AJ)	Experimental	Participants receive the Accountable Justification intervention, but do not receive the Suggested Alternatives or Peer Comparison interventions. Receives: Behavioral: Clinical Decision Support (CDS): Accountable Justifications
Education Control	No intervention	Participants do not receive any of the 3 interventions.

What is being measured

The primary outcome is the main question the study is designed to answer.

Inappropriate Antibiotic Prescribing Rate for Qualifying Acute Respiratory Infection Diagnoses
Assess inappropriate antibiotic prescribing rates (relative to all practices that did not receive the intervention) for antibiotic-inappropriate acute respiratory tract infection visits and no concomitant reason for antibiotic prescribing. based on the following non-antibiotic-appropriate International Statistical Classification of Diseases, version 9 (ICD-9) diagnoses:
460 Acute nasopharyngitis (common cold)
465 Acute laryngopharyngitis/acute upper respiratory infection
466 Acute bronchitis
490 Bronchitis not specified as acute or chronic
487 Flu
Measured: 18 months

Secondary outcomes (1)

Encounters Closely Following the Index Encounter for Serious Diagnoses
Within intervention-qualifying acute respiratory infections (ARI) encounters where no antibiotic was prescribed, we will monitor return visit rates for the specified diagnoses and other acute respiratory infection diagnoses (ICD-9), including whooping cough (033.9), rheumatic fever (390-392) and pneumonia (481-487).
Measured: 18 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

Aug 2011Sep 2014

First posted19 Oct 2011 (estimated)
Study startAug 2011
Primary completionApr 2014
Study completionSep 2014

Resources

Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
Publications (5)Papers the sponsor has linked to this study.
Other trials for Acute Respiratory Infections (ARIs)Studies of the same condition, open and under way.
More trials run by University of Southern CaliforniaThe sponsor's other registered studies.
What the trial phases meanHow a treatment moves from first tests in people to approval.

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design

Study type: Interventional
Phase: Phase N/A
Primary purpose: Treatment
Allocation: Randomised
Intervention model: Factorial
Masking: Single blind
Who is masked: Participant
Enrolment: 248 participants (actual)

IDs, dates and publications

ClinicalTrials.gov ID: NCT01454947
Sponsor's protocol ID: 1RC4AG039115-01
Other IDs: 1RC4AG039115-01
Acronym: BEARI
Status last verified: May 2024
First submitted: 4 Aug 2011
Last updated: 23 May 2024
Results posted: Yes, on ClinicalTrials.gov
Data monitoring committee: Yes

Publications

Meeker D, Linder JA, Fox CR, Friedberg MW, Persell SD, Goldstein NJ, Knight TK, Hay JW, Doctor JN. Effect of Behavioral Interventions on Inappropriate Antibiotic Prescribing Among Primary Care Practices: A Randomized Clinical Trial. JAMA. 2016 Feb 9;315(6):562-70. doi: 10.1001/jama.2016.0275.
PubMed 26864410
Doctor JN, Goldstein NJ, Fox CR, Linder JA, Persell SD, Stewart EP, Knight TK, Meeker D. Clinician Job Satisfaction After Peer Comparison Feedback: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2023 Jun 1;6(6):e2317379. doi: 10.1001/jamanetworkopen.2023.17379.
PubMed 37289454
Gong CL, Zangwill KM, Hay JW, Meeker D, Doctor JN. Behavioral Economics Interventions to Improve Outpatient Antibiotic Prescribing for Acute Respiratory Infections: a Cost-Effectiveness Analysis. J Gen Intern Med. 2019 Jun;34(6):846-854. doi: 10.1007/s11606-018-4467-x. Epub 2018 May 8.
PubMed 29740788
Gong CL, Hay JW, Meeker D, Doctor JN. Prescriber preferences for behavioural economics interventions to improve treatment of acute respiratory infections: a discrete choice experiment. BMJ Open. 2016 Sep 22;6(9):e012739. doi: 10.1136/bmjopen-2016-012739.
PubMed 27660322
Persell SD, Friedberg MW, Meeker D, Linder JA, Fox CR, Goldstein NJ, Shah PD, Knight TK, Doctor JN. Use of behavioral economics and social psychology to improve treatment of acute respiratory infections (BEARI): rationale and design of a cluster randomized controlled trial [1RC4AG039115-01]--study protocol and baseline practice and provider characteristics. BMC Infect Dis. 2013 Jun 27;13:290. doi: 10.1186/1471-2334-13-290.
PubMed 23806017

Want to know more?

The sponsor has not listed a contact. The official record may have more details.

Talk to your doctor first and take this page with you. Only the study team can confirm whether you can join.

Questions to ask the study team

What is the study trying to find out?
What would I need to do, and how often would I visit?
Could I receive a placebo instead of the treatment?
What are the possible risks and benefits for me?
Will it cost me anything? Are travel or time paid for?
Can I keep seeing my own doctor during the study?
What happens when the study ends?

See locations

Enrolling by invitation
Effect of Surgical Masks in Preventing Acute Respiratory Infections
Acute Respiratory Infections (ARIs), Influenza
RecruitingPhase 3
Adaptive Platform Trial of Treatments for Respiratory Infections in Community Settings (TreatResp)
Influenza A, Influenza B
RecruitingObservational study
Clinical Multimodal Surveillance of Respiratory Syndrome Pathogens
Respiratory Tract Infections (RTI), Respiratory Syndrome, Acute, Severe
RecruitingObservational study
FebriDx® Pediatric Validation Study
Acute Respiratory Infections (ARIs)
RecruitingObservational study
Epidemiological Characteristics and Clinical Burden of RSV Infection in Children Under 24 Months in Ho Chi Minh City (2026-2028)
Acute Respiratory Infections (ARIs)

All Acute Respiratory Infections (ARIs) trials

Study at a glance

From the registry record, last updated by the sponsor on 23 May 2024. Recruitment status is as the sponsor reported it: confirm with the study team.

Official title: Use of Behavioral Economics to Improve Treatment of Acute Respiratory Infections (Main Study)
ClinicalTrials.gov ID: NCT01454947
Acronym / sponsor ID: BEARI / 1RC4AG039115-01
Conditions: Acute Respiratory Infections (ARIs)
Keywords: Antibiotics, Inappropriate Prescribing, Respiratory Tract Infections, Behavioral Research
Study type: Interventional
Recruitment status: Completed
Enrolment: 248 participants (actual)
Lead sponsor: University of Southern CaliforniaUniversity, hospital or other
Collaborators: National Institute on Aging (NIA)
Study start: Aug 2011
Primary completion: Apr 2014 (actual)
Study completion: Sep 2014 (actual)
First posted: 19 Oct 2011 (estimated)
Results: Posted 20 Jun 2017

Clinical summary

The research question as the sponsor registered it. This describes what the study plans to test, not what it found.

The objective of this study is to improve provider decisions around treatment of acute respiratory infections.

The outcomes of interest are antibiotic prescribing patterns, including prescribing rates and changes in prescribing rates over time.

Detailed description

Clinicians randomized to the Peer Comparison condition will receive email updates about their antibiotic prescribing practices relative to other clinicians in their practice.

Study design

Primary purpose: Treatment
Allocation: Randomised
Intervention model: Factorial
Masking: Single blind (participant)
Number of arms: 8

Arm	Type	Receives
SA, AJ, PC	Experimental	Behavioral: Clinical Decision Support (CDS): Accountable Justifications, Behavioral: Audit and Feedback: Peer Comparison, Behavioral: CDS Order Sets: Suggested AlternativesParticipants are given all 3 interventions.
SA, AJ	Experimental	Behavioral: Clinical Decision Support (CDS): Accountable Justifications, Behavioral: CDS Order Sets: Suggested AlternativesParticipants receive the Suggested Alternatives and Accountable Justification interventions, but not the Peer Comparison intervention.
SA, PC	Experimental	Behavioral: Audit and Feedback: Peer Comparison, Behavioral: CDS Order Sets: Suggested AlternativesParticipants receive the Suggested Alternative and Peer Comparison interventions, but not the Accountable Justification intervention.
AJ, PC	Experimental	Behavioral: Clinical Decision Support (CDS): Accountable Justifications, Behavioral: Audit and Feedback: Peer ComparisonParticipants receive the Accountable Justification and Peer Comparison interventions, but not the Suggested Alternative intervention.
Peer Comparison (PC)	Experimental	Behavioral: Audit and Feedback: Peer ComparisonParticipants receive the Peer Comparison intervention, but do not receive the Suggested Alternatives or Accountable Justification interventions.
Suggested Alternatives (SA)	Experimental	Behavioral: CDS Order Sets: Suggested AlternativesParticipants receive the Suggested Alternatives intervention, but not the Accountable Justification or Peer Comparison interventions.
Accountable Justification (AJ)	Experimental	Behavioral: Clinical Decision Support (CDS): Accountable JustificationsParticipants receive the Accountable Justification intervention, but do not receive the Suggested Alternatives or Peer Comparison interventions.
Education Control	No intervention	–Participants do not receive any of the 3 interventions.

Who may qualify

Ages: 18 years and older
Sex: All
Healthy volunteers: Not accepted
Age groups: Adult, Older adult

Key inclusion criteria (1 listed)

A practicing attending physician or advanced practice nurse ("provider") at a participating clinic in 2011-2013 who sees acute respiratory infection patients.

Key exclusion criteria (1 listed)

None.

Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.

Interventions

Intervention	Type	Arms
Clinical Decision Support (CDS): Accountable JustificationsAlso: AJ, Accountable JustificationAccountable Justifications triggered by discordant prescriptions that populate the electronic health record (EHR) note with provider's rationale for guideline exceptions (AJ).	Behavioural	AJ, PC, Accountable Justification (AJ), SA, AJ, SA, AJ, PC
Audit and Feedback: Peer ComparisonAlso: PC, Peer ComparisonPerformance feedback that benchmarks providers' own performance to that of their peers (PC, for Peer Comparison).	Behavioural	AJ, PC, Peer Comparison (PC), SA, AJ, PC, SA, PC
CDS Order Sets: Suggested AlternativesAlso: SA, Suggested AlternativesOrder Sets that are triggered by EHR workflow containing exclusively guideline concordant choices (SA, for Suggested Alternatives).	Behavioural	SA, AJ, SA, AJ, PC, SA, PC, Suggested Alternatives (SA)

Primary outcome

Inappropriate Antibiotic Prescribing Rate for Qualifying Acute Respiratory Infection Diagnoses
Time frame: 18 months
Assess inappropriate antibiotic prescribing rates (relative to all practices that did not receive the intervention) for antibiotic-inappropriate acute respiratory tract infection visits and no concomitant reason for antibiotic prescribing. based on the following non-antibiotic-appropriate International Statistical Classification of Diseases, version 9 (ICD-9) diagnoses: 460 Acute nasopharyngitis (common cold) 465 Acute laryngopharyngitis/acute upper respiratory infection 466 Acute bronchitis 490 Bronchitis not specified as acute or chronic 487 Flu

1 secondary outcome

Encounters Closely Following the Index Encounter for Serious Diagnoses
Time frame: 18 months

Results and safety

Results posted to the registry on 20 Jun 2017, as reported by the sponsor. Figures are copied from the record, not re-analysed. Full results on ClinicalTrials.gov.

Participant flow

Group	Started	Completed
Education Control	27	24
Suggested Alternatives (SA)	42	38
Accountable Justification (AJ)	35	32
Peer Comparison (PC)	20	19
SA, AJ	34	33
SA, PC	35	32
AJ, PC	27	26
SA, AJ, PC	28	23

Primary outcome: Inappropriate Antibiotic Prescribing Rate for Qualifying Acute Respiratory Infection Diagnoses

Time frame: 18 months. Number (95% Confidence Interval). Unit: proportion of visits

Measure	Control n = 27	Suggested Alternatives (SA) n = 42	Accountable Justification (AJ) n = 35	Peer Comparison (PC) n = 20	Suggested Alternatives + Accountable Justification n = 34	Suggested Alternatives + Peer Comparison n = 35	Accountable Justification + Peer Comparison n = 27	SA+AJ+PC n = 28
Value	0.20 (0.10 to 0.31)	0.19 (0.06 to 0.66)	0.08 (0.03 to 0.23)	0.09 (0.03 to 0.31)	0.07 (0.02 to 0.24)	0.01 (0.00 to 0.08)	0.03 (0.00 to 0.18)	0.03 (0.00 to 0.22)

Population analysed: We identified a total of 16,959 non-antibiotic-appropriate acute respiratory infection (ARI) visits. Visits were categorized as inappropriate if there were diagnosis codes for non-specific upper respiratory infections, acute bronchitis, and/or influenza.

1 secondary outcome is reported in the full results.

Adverse events

Time frame: For antibiotic-inappropriate visits in which no antibiotic was prescribed, we assessed return visits within 30 days for the presence of complications potentially attributable to untreated bacterial infections. Other adverse events reported at 0% frequency or more

Group	Serious adverse events	Other adverse events	Deaths
Education Control	0 of 3,245 (0%)	14 of 3,245 (0.4%)	Not reported
Suggested Alternatives (SA)	0 of 4,579 (0%)	16 of 4,579 (0.3%)	Not reported
Accountable Justification (AJ)	0 of 4,622 (0%)	16 of 4,622 (0.3%)	Not reported
Peer Comparison (PC)	0 of 3,781 (0%)	13 of 3,781 (0.3%)	Not reported
SA, AJ	0 of 5,717 (0%)	22 of 5,717 (0.4%)	Not reported
SA, PC	0 of 5,993 (0%)	23 of 5,993 (0.4%)	Not reported
AJ, PC	0 of 3,398 (0%)	48 of 3,398 (1.4%)	Not reported
SA, AJ, PC	0 of 4,164 (0%)	15 of 4,164 (0.4%)	Not reported

Loading the posted results from ClinicalTrials.gov…

Research links

Official record on ClinicalTrials.govLast updated by the sponsor 23 May 2024.
Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
Background: PubMed 26864410Meeker D, Linder JA, Fox CR, Friedberg MW, Persell SD, Goldstein NJ, Knight TK, Hay JW, Doctor JN. Effect of Behavioral Interventions on Inappropriate Antibiotic Prescribing Among Primary Care Practices: A Randomized Clinical Trial. JAMA. 2016 Feb 9;315(6):562-70. doi: 10.1001/jama.2016.0275.
Derived from this study: PubMed 37289454Doctor JN, Goldstein NJ, Fox CR, Linder JA, Persell SD, Stewart EP, Knight TK, Meeker D. Clinician Job Satisfaction After Peer Comparison Feedback: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2023 Jun 1;6(6):e2317379. doi: 10.1001/jamanetworkopen.2023.17379.
Derived from this study: PubMed 29740788Gong CL, Zangwill KM, Hay JW, Meeker D, Doctor JN. Behavioral Economics Interventions to Improve Outpatient Antibiotic Prescribing for Acute Respiratory Infections: a Cost-Effectiveness Analysis. J Gen Intern Med. 2019 Jun;34(6):846-854. doi: 10.1007/s11606-018-4467-x. Epub 2018 May 8.
Derived from this study: PubMed 27660322Gong CL, Hay JW, Meeker D, Doctor JN. Prescriber preferences for behavioural economics interventions to improve treatment of acute respiratory infections: a discrete choice experiment. BMJ Open. 2016 Sep 22;6(9):e012739. doi: 10.1136/bmjopen-2016-012739.
Derived from this study: PubMed 23806017Persell SD, Friedberg MW, Meeker D, Linder JA, Fox CR, Goldstein NJ, Shah PD, Knight TK, Doctor JN. Use of behavioral economics and social psychology to improve treatment of acute respiratory infections (BEARI): rationale and design of a cluster randomized controlled trial [1RC4AG039115-01]--study protocol and baseline practice and provider characteristics. BMC Infect Dis. 2013 Jun 27;13:290. doi: 10.1186/1471-2334-13-290.

Related trials for Acute Respiratory Infections (ARIs)

Enrolling by invitation
Effect of Surgical Masks in Preventing Acute Respiratory Infections
Acute Respiratory Infections (ARIs), Influenza
RecruitingPhase 3
Adaptive Platform Trial of Treatments for Respiratory Infections in Community Settings (TreatResp)
Influenza A, Influenza B
RecruitingObservational study
Clinical Multimodal Surveillance of Respiratory Syndrome Pathogens
Respiratory Tract Infections (RTI), Respiratory Syndrome, Acute, Severe
RecruitingObservational study
FebriDx® Pediatric Validation Study
Acute Respiratory Infections (ARIs)
RecruitingObservational study
Epidemiological Characteristics and Clinical Burden of RSV Infection in Children Under 24 Months in Ho Chi Minh City (2026-2028)
Acute Respiratory Infections (ARIs)

Referral and contact

AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.

Jason N Doctor, PhD principal investigator

University of Southern California

55 sites in 1 country: see every site and its status.

Questions about this trial

What is this clinical trial studying?

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 23 May 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 55 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 20 Jun 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Inappropriate Antibiotic Prescribing Rate for Qualifying Acute Respiratory Infection Diagnoses (time frame: 18 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01454947, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 May 2024.