The Effect of AUDIT and Feedback on Pneumococcal Vaccination Coverage
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ClinicalTrials.gov Identifier: NCT05920499 |
Recruitment Status :
Recruiting
First Posted : June 27, 2023
Last Update Posted : June 27, 2023
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The goal of this cluster-randomized trial is to study the effect of Audit and Feedback loops on pneumococcal vaccination coverage rate in adults at risk in general practice.
The main questions it aims to answer are:
- To assess the effect of "clinical AUDIT and feedback" loops on the pneumococcal vaccination coverage rate in adults at risk in general practice.
- To explore whether the increase in vaccination coverage rate after implementation of Audit and Feedback loops is different in specific subgroups (risk groups, male/female, age, smoking status).
Every general practice center assigned to the control or intervention group will have access to a clinical AUDIT to identify patients that may benefit from a pneumococcal vaccination. The general practice centers in the intervention group will also receive an individualized extended electronic feedback report, with multiple components like benchmarked performances and action plans, at baseline and each 2 months from baseline onwards.
Condition or disease | Intervention/treatment | Phase |
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Pneumococcal Infections | Other: AUDIT and Feedback | Not Applicable |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 36 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Masking Description: | Due to the nature of the study it is not possible to blind at the practice level. Physicians will always be aware to which group they belong. At Healthdata (data collection) practices included in the intervention group will be identified so the extended feedback report can be made available only to them. |
Primary Purpose: | Prevention |
Official Title: | The Effect of AUDIT and Feedback on Pneumococcal Vaccination Coverage in Adults at Risk in General Practice: a Cluster Randomized Trial |
Estimated Study Start Date : | September 30, 2023 |
Estimated Primary Completion Date : | October 1, 2024 |
Estimated Study Completion Date : | October 31, 2024 |
Arm | Intervention/treatment |
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Experimental: Intervention group
The INTEGO practices (INTEGO is a GP morbidity registry in Flanders Belgium) that will be assigned to the intervention group will receive an extended electronic feedback report with multiple components, directly implemented in their EHR (electronic health record), on the pneumococcal vaccination coverage in adults at risk in their practice ('push system'). There will be a direct connection between the EHR of the practice and a SAS visual analytics tool in the Healthdata environment (single-sign-on connection), that will show the extended feedback. This report will be available at baseline and updated every two months based on the current situation.
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Other: AUDIT and Feedback
AUDIT and Feedback is a well-known quality intervention that according to the last Cochrane review leads to "small but potentially important improvements in professional practice" (Ivers N et al. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev 2012, 6:Cd000259). Standardized automated AUDITs are available in most EHR systems in Belgium. Feedback, on the other hand, is only available in specific registration networks. At study baseline the performance in INTEGO practices will be measured. Afterwards a standardized clinical AUDIT to identify patients that may benefit from pneumococcal vaccination will be implemented in the EHR of all INTEGO practices. The Feedback will only be implemented in the intervention group. |
Active Comparator: Control group
Every GP center assigned to the control group will only have access to the clinical AUDIT to identify patients that may benefit from a pneumococcal vaccination. GP centers in the control group will not receive an extended feedback report at baseline and every 2 months afterwards.
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Other: AUDIT and Feedback
AUDIT and Feedback is a well-known quality intervention that according to the last Cochrane review leads to "small but potentially important improvements in professional practice" (Ivers N et al. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev 2012, 6:Cd000259). Standardized automated AUDITs are available in most EHR systems in Belgium. Feedback, on the other hand, is only available in specific registration networks. At study baseline the performance in INTEGO practices will be measured. Afterwards a standardized clinical AUDIT to identify patients that may benefit from pneumococcal vaccination will be implemented in the EHR of all INTEGO practices. The Feedback will only be implemented in the intervention group. |
- Vaccination coverage rate (VCR) [ Time Frame: 12 months ]Vaccination coverage rate (VCR) in the three defined risk groups for pneumococcal infections.
- Vaccination coverage rate (VCR) in specific subgroups [ Time Frame: 12 months ]Vaccination coverage rate (VCR) in specific subgroups (other risk groups, smoker - non-smoker, age - gender subgroups).
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Ages Eligible for Study: | 16 Years to 85 Years (Child, Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria
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To be eligible for inclusion in the study, general practice (GP) centers must conform to the following conditions:
- It is a Flemish GP center in the INTEGO network.
- The GP center uses an electronic health record (EHR), automatically linked to the INTEGO database.
- The physician (one per center, in name of all GPs in that center) signs a specific study consent form.
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To be eligible for inclusion in the study, patients must conform to the following conditions:
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The patient belongs to a target group for pneumococcal vaccination (based on https://www.health.belgium.be/sites/default/files/uploads/fields/fpshealth_theme_file/hgr_9562_vaccinatie_tegen_pneumokokken_vweb.pdf):
A. Adults aged 16 - 85 years old with a high risk for a pneumococcal infection
- Adults with an immunity disorder
- Adults with anatomical and / or functional asplenia, sickle-cell disease or hemoglobinopathy
- Adults with cerebrospinal fluid or cochlear implant leakage B. Adults (aged 50 - 85 years old) with comorbidity
- Chronic cardiac disease
- Chronic pulmonary disease or smoker
- Chronic liver disease or ethylabusus
- Chronic kidney disease
- Chronic neurological or neuromuscular disorders with aspiration risk
- Diabetes mellitus C. Healthy persons aged 65 - 85 years old
- The patient has an electronic medical record (EMR) in the participating general practice centre. This EMR contains all the patient information, for instance regarding medical history and medication and is managed by the general practitioner.
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Exclusion criteria
- Patients excluded from feedback: patients not belonging to one of the target groups for pneumococcal vaccination.
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Patients excluded from AUDIT: patients not belonging to one of the target groups for pneumococcal vaccination OR
- Correctly vaccinated high-risk patients (PPV23 less than 5 years ago AND PCV13 ever received)
- Correctly vaccinated adults with comorbidity (1) PCV13 ever received AND PPV23 less than 5 years ago, OR 2) PCV13 ever received AND 2x PPV23 vaccination more than 5 years ago)
- Correctly vaccinated healthy persons (PPV23 ever received)
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05920499
Contact: Bert Vaes, MD, PhD | +32 16 37 72 97 | bert.vaes@kuleuven.be | |
Contact: Arne Janssens, Msc | +32 16 37 66 21 | arne.janssens@kuleuven.be |
Belgium | |
Academic Center of General Practice | Recruiting |
Leuven, Belgium, 3000 | |
Contact: Tine De Burghgraeve, PhD +32 16 37 66 21 tine.deburghgraeve@kuleuven.be | |
Contact: Margriet de Jong +32 16 37 66 21 margriet.dejong@kuleuven.be |
Principal Investigator: | Bert Vaes, MD, PhD | Department of Public Health and Primary Care, KU Leuven |
Publications:
Responsible Party: | Bert Vaes, Associate Professor, KU Leuven |
ClinicalTrials.gov Identifier: | NCT05920499 |
Other Study ID Numbers: |
S66253 |
First Posted: | June 27, 2023 Key Record Dates |
Last Update Posted: | June 27, 2023 |
Last Verified: | June 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Plan Description: | The individual INTEGO patient data is hosted on Healthdata, in a secured data environment. Patient data will be aggregated on a practice level to produce the feedback. These aggregated data will also be used to evaluate the vaccination coverage rate, the outcome of this study. The aggregated data per practice could be made available to other researchers upon reasonable request. |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
AUDIT Feedback general practice pneumococcal vaccination rate |
Pneumococcal Infections Streptococcal Infections Gram-Positive Bacterial Infections |
Bacterial Infections Bacterial Infections and Mycoses Infections |