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The effect of using an interactive booklet on childhood respiratory tract infections in consultations: study protocol
Nick A Francis1, Kerenza Hood, Sharon Simpson
1South East Wales Trials Unit, Department of Primary Care and Public Health, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4XN, UK. francisna@cardiff.ac.uk
Insights
Providing parents with an interactive booklet on childhood respiratory tract infections during primary care consultations may reduce re-consultations and antibiotic prescribing. This study protocol outlines a cluster randomized controlled trial to evaluate this intervention.
Area of Science:
- Pediatric primary care
- Infectious disease management
- Health services research
Background:
- Respiratory tract infections (RTIs) are common in children, leading to frequent primary care visits and unnecessary antibiotic prescriptions.
- A significant proportion of children re-consult for the same RTI episode, highlighting a need for improved management strategies.
- Parental education on RTIs has the potential to reduce re-consultation rates and antibiotic use.
Purpose of the Study:
- To evaluate the effectiveness of an interactive booklet on childhood RTIs when used within primary care consultations.
- To determine if the intervention reduces re-consultation rates and antibiotic prescribing for RTIs in children.
- To assess the impact on parental satisfaction, enablement, and healthcare costs.
Main Methods:
- Cluster randomized controlled trial involving general practices.
- Intervention group receives an interactive booklet on RTIs for parents, alongside usual care.
- Control group receives usual care only.
- Outcomes assessed via telephone interview at two weeks; practice notes reviewed for consultation rates over one year.
Main Results:
- The primary outcome is the proportion of children re-consulting for the same RTI episode.
- Secondary outcomes include antibiotic use, parental satisfaction, enablement, and illness costs.
- Consultation rates for RTIs over the subsequent year will be analyzed.
Conclusions:
- Previous studies suggest educational interventions can lower re-consultation and antibiotic use for RTIs.
- This study is the first to investigate the impact of a parent-focused, clinician-delivered interactive booklet on childhood RTIs in primary care.
- The research aims to confirm reduced re-consultations and antibiotic use without compromising patient satisfaction.
Background:
Respiratory tract infections in children result in more primary care consultations than any other acute condition, and are the most common reason for prescribing antibiotics (which are largely unnecessary). About a fifth of children consult again for the same illness episode. Providing parents with written information on respiratory tract infections may result in a reduction in re-consultation rates and antibiotic prescribing for these illnesses. Asking clinicians to provide and discuss the information during the consultation may enhance effectiveness. This paper outlines the protocol for a study designed to evaluate the use of a booklet on respiratory tract infections in children within primary care consultations.
Methods/Design:
This will be a cluster randomised controlled trial. General practices will be randomised to provide parents consulting because their child has an acute respiratory tract infection with either an interactive booklet, or usual care. The booklet provides information on the expected duration of their child's illness, the likely benefits of various treatment options, signs and symptoms that should prompt re-consultation, and symptomatic treatment advice. It has been designed for use within the consultation and aims to enhance communication through the use of specific prompts. Clinicians randomised to using the interactive booklet will receive online training in its use. Outcomes will be assessed via a telephone interview with the parent two weeks after first consulting. The primary outcome will be the proportion of children who re-consult for the same illness episode. Secondary outcomes include: antibiotic use, parental satisfaction and enablement, and illness costs. Consultation rates for respiratory tract infections for the subsequent year will be assessed by a review of practice notes.
Discussion:
Previous studies in adults and children have shown that educational interventions can result in reductions in re-consultation rates and use of antibiotics for respiratory tract infections. This will be the first study to determine whether providing parents with a booklet on respiratory tract infections in children, and discussing it with them during the consultation, reduces re-consultations and antibiotic use for the same illness without reducing satisfaction with care.
Trial Registration:
Current Controlled Trials ISRCTN46104365.
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