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| Name | Class |
|---|---|
| Göteborg University | OTHER |
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This project aims to investigate if an organisational change of patient flow away from medical practitioners can reduce unnecessary antibiotic prescribing in patients attending with a sore throat as the main complaint.
Today patients appear either at a PHC centre or at the Pharmacy. The Pharmacy may provide advice on analgesic or refer the patient to a PHC centre. At the PHC centre, the patient may first appear to the medical practitioner or a nurse pending on local routines. The current Swedish guideline recommends no antibiotics and no testing for patients with 0-2 Centor criteria. For patients with 3-4 Centor criteria the guideline recommends testing and only consider antibiotics if GAS is present.
COVID-19 has gradually transformed from expressing itself as a severe lower respiratory tract infection to be more of an upper respiratory tract infection. Furthermore, COVID-19 is likely to transform from a pandemic to an endemic state with a low continuous incidence. Hence, in response to COVID-19 it seems crucial to identify to what extent the common sore throat is caused by the SARS-CoV-2.
Furthermore, a large controlled clinical trial is required to sort out if patients attending with a sore throat as the main complaint are best managed by medical practitioners, nurses or pharmacists. This study aims to perform such a controlled clinical trial comparing the outcome of sore throat patients management by medical practitioner, nurses and pharmacists. This study also aims to investigate to what extent the SARS-CoV-2 virus is identified in these patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Initial assessement by physicians | Active Comparator | Patients attending with an acute sore throat are initially assessed by a physician. This is one variant of current standard practice. |
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| Initial assessement by nurses | Active Comparator | Patients attending with an acute sore throat are initially assessed by a nurse. This is one variant of current standard practice. |
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| Initial assessement by pharmacists | Experimental | Patients attending with an acute sore throat are initially assessed by a pharmacist. This is officially not standard practice in Sweden, although it happens. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Physicians assess patients | Behavioral | Physicians are asked to assess patients following the current Swedish guideline |
|
| Measure | Description | Time Frame |
|---|---|---|
| Guideline adherence | Will the proportion of patients attending for an uncomplicated acute sore throat being managed according to prevailing guidelines differ if the initial assessment is made by a medical practitioner, a trained nurse or a trained pharmacist | Immediately after the consultation |
| Measure | Description | Time Frame |
|---|---|---|
| Illness severity | What proportion of patients attending PHC centres or pharmacies are classified as apparently uncomplicated, potentially complicated or potentially critically ill | Immediately after the consultation |
| Type of patients seeking care |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Carl Wikberg, PhD | Contact | +46703821660 | carl.wikberg@allmed.gu.se |
| Name | Affiliation | Role |
|---|---|---|
| Ronny Gunnarsson, PhD | University of Gothenburg and Region Vastra Gotaland | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Apoteket | Recruiting | Stenungsund | 4430 | Sweden |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Mar 17, 2023 | Oct 27, 2023 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D010612 | Pharyngitis |
| ID | Term |
|---|---|
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D010608 | Pharyngeal Diseases |
| D009057 | Stomatognathic Diseases |
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Parallel groups each with different interventions.
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| Nurses assess patients | Behavioral | Nurses are asked to assess patients following the current Swedish guideline |
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| Pharmacists assess patients | Behavioral | Pharmacists are asked to assess patients following the current Swedish guideline |
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Will patient characteristics differ if the patient first appears to the medical practitioner, a trained nurse or a trained pharmacist?
| Immediately after the consultation |
| Presence of SARS-CoV-2 virus | To what extent do patients attending Primary Health Care/Pharmacies due to an acute sore throat harbour the SARS-CoV-2 virus? | Immediately after the consultation |
| Närhälsan Stenungsund Vårdcentral | Recruiting | Stenungsund | 44430 | Sweden |
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| Praktikertjänst Hälsobrunnen Vårdcentral | Recruiting | Ulricehamn | 52337 | Sweden |
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| Apoteksgruppen | Recruiting | Ulricehamn | Sweden |
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| D012140 |
| Respiratory Tract Diseases |
| D010038 | Otorhinolaryngologic Diseases |