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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04705259
Registration number
NCT04705259
Ethics application status
Date submitted
3/12/2020
Date registered
12/01/2021
Date last updated
14/10/2021
Titles & IDs
Public title
A Multimodal Intervention to Optimise Antimicrobial Use in Residential Aged Care Facilities (ENGAGEMENT Study)
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Scientific title
A Multimodal Intervention to Optimise Antimicrobial Use in Residential Aged Care Facilities (ENGAGEMENT Study): Protocol for a Stepped Wedge Cluster Randomised Trial
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Secondary ID [1]
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2020002193
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Universal Trial Number (UTN)
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Trial acronym
ENGAGEMENT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Antimicrobial Stewardship
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Antibiotics Causing Adverse Effects in Therapeutic Use
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Condition category
Condition code
Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
BEHAVIORAL - Antimicrobial Stewardship ENGAGEMENT bundle
Active comparator: ENGAGEMENT bundle - A multimodal bundle of interventions to optimise antibiotic prescribing in residential aged care facilities. The bundle includes education for nurses and general practitioners caring for residents, telehealth support and implementation of state-wide guidelines.
Placebo comparator: Usual care - Usual facility practices with regards to antibiotic prescribing and review
BEHAVIORAL: Antimicrobial Stewardship ENGAGEMENT bundle
Given that a single intervention is unlikely to be effective in stewardship programs, nor in care improvement processes at RACFs \[7\], this trial will deliver a set of multimodal, multidisciplinary interventions to optimise antibiotic use in RACFs. This RACF AMS ENGAGEMENT bundle will comprise the following key interventions:
* Education and engagement of prescribers, nurses, pharmacists and residents and family members
* Nursing initiatives to improve UTI diagnosis and reduce inappropriate urine testing
* Guideline development specific to antibiotic use in RACF residents
* Antimicrobial stewardship team creation in RACF with GP involvement
* EMergency department liaison and use of clinical pathways to ensure consistency of practice across the care continuum
* ElectroNic decision support to guide RACF urine testing and GP antibiotic prescribing
* Telehealth support for key intervention components
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Intervention code [1]
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BEHAVIORAL
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Defined Daily Doses (DDDs) of Antibiotics
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Assessment method [1]
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The primary outcome measure for this trial is antibiotic use as measured by DDDs of antibiotics per 1000 resident bed days.
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Timepoint [1]
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18 months
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Secondary outcome [1]
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Urine Samples
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Assessment method [1]
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Number of urine samples collected per 1000 resident bed days between the control vs intervention periods
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Timepoint [1]
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18 months
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Secondary outcome [2]
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Susceptibility of pathogens
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Assessment method [2]
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Percent susceptibility of Enterobacteriaceae to ceftriaxone, ciprofloxacin, cephalexin and amoxicillin-clavulanate measured using antibiograms
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Timepoint [2]
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18 months
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Secondary outcome [3]
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All cause on-year mortality
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Assessment method [3]
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All-cause on-year mortality rates of residential aged care facility (RACF) residents between the control vs intervention periods (per 1000 resident bed days and median rate across facilities)
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Timepoint [3]
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18 months
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Secondary outcome [4]
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Hospital admissions
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Assessment method [4]
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Number of RACF residents admitted to hospital during the control vs intervention periods (per 1000 resident bed days and median rate across facilities)
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Timepoint [4]
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18 months
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Eligibility
Key inclusion criteria
Eligibility is at the Residential Aged Care Facility (RACF) level. If the facility is eligible to participate de-identified data from all facility residents will be included for the duration of the the study.
* All residents of RACFs with at least 50 residents
* RACFs located in South East Queensland, Australia
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
* RACFs with less than 50 residents;
* RACFs unable to provide reports for baseline data
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Study design
Purpose of the study
Other
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
UNKNOWN
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/10/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
24/12/2022
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Actual
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Sample size
Target
18
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
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Bethany Christian Care - Eight Mile Plains
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Recruitment hospital [2]
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Carinity Aged Care - Mitchelton
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Recruitment hospital [3]
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Beaumont Care - Rothwell
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Recruitment hospital [4]
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Vacenti Aged Care - Upper Mount Gravatt
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Recruitment postcode(s) [1]
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4113 - Eight Mile Plains
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Recruitment postcode(s) [2]
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4053 - Mitchelton
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Recruitment postcode(s) [3]
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4022 - Rothwell
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Recruitment postcode(s) [4]
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4122 - Upper Mount Gravatt
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Funding & Sponsors
Primary sponsor type
Other
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Name
The University of Queensland
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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National Health and Medical Research Council, Australia
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
The antimicrobial stewardship ENGAGEMENT study aims to deliver a bundle of interventions, including education of GPs and nursing staff, guideline implementation and telehealth support for 18 residential aged care facilities (RACFs) in Queensland Australia to help optimise antibiotic prescribing and reduce inappropriate use. The trial will involve 18 licenced RACFs with 50 or more residents and is set to commence in June 2021.
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Trial website
https://clinicaltrials.gov/study/NCT04705259
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Trial related presentations / publications
Falconer N, Paterson DL, Peel N, Welch A, Freeman C, Burkett E, Hubbard R, Comans T, Hanjani LS, Pascoe E, Hawley C, Gray L. A multimodal intervention to optimise antimicrobial use in residential aged care facilities (ENGAGEMENT): protocol for a stepped-wedge cluster randomised trial. Trials. 2022 May 21;23(1):427. doi: 10.1186/s13063-022-06323-8.
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Public notes
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Contacts
Principal investigator
Name
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Address
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Alyssa Welch
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Address
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Country
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Phone
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+61438629310
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Fax
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Email
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[email protected]
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04705259
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