Reducing antibiotic prescribing by enhancing communication of general practitioners with their immigrant patients: Protocol for a randomised controlled trial (PARCA study)

Dominique Lescure, Janneke Van Der Velden, Daan Nieboer, Wilbert Van Oorschot, Rob Brouwer, Natascha Huijser Van Reenen, Aimée Tjon-A-Tsien, Ozcan Erdem, Margreet Vos, Alike Van Der Velden, Jan Hendrik Richardus, Hélène Voeten*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Introduction 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). Methods and analysis 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. Ethics and dissemination 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). Trial registration number NL9450.

Original languageEnglish
Article numbere054674
Number of pages7
JournalBMJ Open
Volume11
Issue number10
DOIs
Publication statusPublished - 11 Oct 2021

Bibliographical note

Funding: The work is supported by The Netherlands Organisation for Health
Research and Development, ZonMw (Postbus 93245, 2509 AE Den Haag, The
Netherlands), grant number 50-54100-98-209.

Publisher Copyright:
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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