UNSTRUCTURED
ABSTRACT
Background
Antibiotic resistance is a global issue that has a significant impact on patient morbidity and mortality. Evidence exists within the general practice and the emergency department setting to suggest that antimicrobial overuse is a significant contributor to resistance. Upper respiratory tract infections are a group of conditions for which antibiotics may be inappropriately prescribed. Patient decision aids are tools allowing for shared decision making between clinician and patient, incorporating patient values and the latest evidence into the decision of whether to prescribe antibiotics or not.
Objectives
To determine if patient decision aids are effective in decreasing antibiotic prescription for acute upper respiratory tract infections during general practice and emergency department encounters, and to comment on the depth of literature available in this field.
Methods and Analysis
We have established a protocol for a systematic review to assess the efficacy of patient decision aids in reducing antibiotic prescription for upper respiratory tract infections in general practices and emergency departments. A set of inclusion criteria has been established. We will include systematic reviews and randomised controlled trials only. A search strategy was formed and will be used in the Medline, Embase, ScienceDirect and Cochrane databases as well as sources of unpublished literature. Primary and secondary outcomes will focus on immediate and longer-term antibiotic prescription rate and patient decision aid efficacy. We have established a literature screening process and criteria for quantitative synthesis. Literature screening and study quality assessment will be carried out by two independent and blinded reviewers. We will use a single data extraction protocol.
Results
We are yet to start any formal data collection or analysis but have secured funding from Mackay Institute of Research and Innovation.
Ethics and Dissemination
It was decided that this systematic review protocol did not require ethical approval. Study sponsors will be communicated with regularly regarding the study, which will be published in a journal in the relevant field. Any updates to the protocol will be published as required.
Registration
Prospero registration number: CRD42017069598
Keywords
Patient decision aid; Shared decision making; Upper respiratory tract infection; Antibiotic prescription; General practice; Emergency department