This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
Doctors and other clinicians write millions of prescriptions for antibiotics for children each year, most often for nose, throat, ear, and chest infections. However, children with the common cold, flu or other infections caused by viruses -- and not by bacteria -- do not need antibiotics to get better. When a child uses an antibiotic when it isn’t necessary, bacteria in the body can get used to the medicine and may become resistant to it. In the future, the antibiotic might not work on these bacteria when the child or other people need it.
One cause for the overuse of antibiotics is poor communication between parents and clinicians. Clinicians may give unneeded antibiotics to children because parents ask for them, or because they worry that parents will be unhappy if their children don’t get them.
This study is comparing two proven ways to reduce antibiotic use. The first is parent-clinician education. The second is parent-clinician education plus communication skills training for clinicians.
Who can this research help?
Healthcare clinics can use findings from this study when looking at ways to help clinicians reduce unnecessary antibiotic use in children.
What is the research team doing?
All clinicians in the study are attending a 20-minute training on correct use of antibiotics to treat common nose, throat, ear, and chest infections. The research team is assigning half of the clinicians by chance to get an extra 50-minute training on how to talk to parents about treating these infections.
The research team is enrolling 1,600 parents or legal guardians of children ages 1 to 5 who have appointments with study clinicians for symptoms of nose, throat, ear, or chest infections. Before they meet with a clinician, parents use a computer tablet to watch a 90-second cartoon video and view an information sheet. These materials provide information about when antibiotics can help their child, when they aren’t needed, and the risks of using antibiotics when they aren’t needed.
Parents scheduled to see a clinician who has had the extra communication training get a brochure. It includes the educational information as well as a checklist to use when talking to clinicians about antibiotics.
Parents are answering questions on the tablet before and after the appointment. They rate how well the clinician worked with them to make decisions about their child’s care. They also rate their satisfaction with the visit. The research team is reviewing children’s medical records to learn whether the child’s clinician prescribed antibiotics and if they were needed. After two weeks, the team is calling parents to ask if the child’s symptoms have improved, if they needed another visit for their illness, and if they had side effects from any antibiotics they received.
English- and Spanish-speaking parents from the community helped the research team design study materials and plan the study.
Research methods at a glance
- Carey Bickford
Other Stakeholder Partners
- Christopher C. Butler, BA, MBChB, DCH, MD, FRCGP, (Hon) FFPH
- Bob Finuf, Executive Director of Integrated Care Solutions
- David Yu, MD, President of Heartland Primary Care