Intervention component | Study arm | Description | Primary objectives | Secondary objectives |
---|---|---|---|---|
GP focused | ||||
Coding workshop | All arms | Demonstrate the purpose of electronically coding UTI consultations using coding guidelines (International Classification of Primary Care code U71) and how to implement uniform coding in routine practice. | Promote routine uniform consultation coding for UTIs. | Gather baseline practice data and knowledge and attitudinal data (questionnaires). |
Interactive workshop A | Intervention arm A | Raise the profile of GPs’ antimicrobial prescribing behaviours and their role in the broader issue of AMR. | Encourage GPs to become more aware of their antimicrobial prescribing behaviours through discussion of their role in the development of AMR. | Process evaluation |
Provide guidance on antimicrobial prescribing through adherence to guideline for UTI. | ||||
Interactive workshop B | Intervention arm B | In addition to the core components of interactive workshop A, the recommendation to delay antimicrobial prescribing for UTIs facilitated through shared decision making will be promoted. | Encourage the use of delayed prescribing for UTIs. | |
Process evaluation. | ||||
Electronic audit and feedback reports | Intervention arms A and B | A monthly report will be available (electronically) to practices summarizing their antimicrobial prescribing patterns for UTIs and antimicrobial resistance patterns of E. coli. | To provide a comparison of antimicrobial prescribing for UTIs between practices. | To provide an overview of antimicrobial resistance patterns in E. coli causing UTIs. |
Stakeholder awareness | Information about the intervention and the issue of AMR will be provided to other stakeholders; pharmacists, practice receptionists and practice nurses. | To update all stakeholders on the overall aim of the intervention. | ||
Computer “prompt” application | Intervention arm A | Upon entry of the uniform UTI code, automated electronic prompts will appear on the GPs computer screen. | Provide the recommended antimicrobial treatment for a UTIs. | Remind the GP to collect urine samples and patients’ mobile telephone numbers. |
Intervention arm B | Provide the recommended antimicrobial treatment for a UTI and suggest delayed prescribing. | |||
Patient focused components | ||||
Informational leaflets | Intervention arms A and B | Leaflets will outline the aim of the SIMPle study and highlight issues relating to consuming antibiotics. Intervention arm B patients will receive additional information, outlining the benefits of delayed prescribing for UTIs. | To increase awareness of the side effects, resistance and lack of the availability of new antibiotics. | To inform the patient of the study. To support the use of delayed prescribing for UTIs (patients in intervention group B only). |
Educational infomercial | An educational video will be displayed in practice waiting rooms. The video will outline the key issues associated with AMR to patients. | |||
GP and patient focused components | ||||
Website | Intervention arms A and B | The website will provide more information on the issues of AMR. | To provide access to an online survey. | Provide background to the SIMPle study. |