Impact of point-of-care C-reactive protein testing intervention on non-prescription dispensing of antibiotics for respiratory tract infections in private community pharmacies in Nigeria: a cluster randomized controlled trial
Objectives: To ascertain if access to C-reactive protein (CRP) test kits—and staff training on how to use them in respiratory tract infection (RTI) management—in private community pharmacies (PCPs) can reduce non-prescription antibiotic dispensing for RTI. Methods: A parallel cluster randomized cont...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-02-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971222006440 |
| _version_ | 1797943120033218560 |
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| author | Augustine Onwunduba Obinna Ekwunife Ebuka Onyilogwu |
| author_facet | Augustine Onwunduba Obinna Ekwunife Ebuka Onyilogwu |
| author_sort | Augustine Onwunduba |
| collection | DOAJ |
| description | Objectives: To ascertain if access to C-reactive protein (CRP) test kits—and staff training on how to use them in respiratory tract infection (RTI) management—in private community pharmacies (PCPs) can reduce non-prescription antibiotic dispensing for RTI. Methods: A parallel cluster randomized controlled trial was conducted in Nigeria. The clusters—which were equally the participating units—were PCPs with blood testing experience. Stratified block randomization was done. PCPs were stratified by the baseline value of the primary outcome. PCPs were not blinded. The intervention PCPs were provided with CRP kits and trained to use them to make decisions regarding non-prescription antibiotic dispensing for RTI. The control PCPs received no intervention. The primary outcome was the non-prescription antibiotic dispensing rate for RTI. Data were collected by blinded simulated clients who visited each PCP 30 times before and after the intervention without prescriptions. Analyses were by intention-to-treat. Results: Twenty PCPs were randomized, 1:1. Ten PCPs were analyzed in each arm. Each PCP contributed 30 data points to the multiple imputation analysis where antibiotic dispensing decreased by 15.66% (209/300 [intervention] vs 256/300 [control]) in the adjusted analysis (odds ratio = 0·279, 95% confidence interval = 0.107-0.726; P-value = 0.0090) and 16% (208/300 [intervention] vs 256/300 [control]) in the crude analysis (odds ratio = 0.299, 95% confidence interval = 0.098-0.911; P-value = 0.034). Conclusion: Access to CRP kits—and staff training on how to use them in RTI management—in PCPs reduced non-prescription antibiotic dispensing for RTI. |
| first_indexed | 2024-04-10T20:18:14Z |
| format | Article |
| id | doaj.art-d899a0dd77cf44c4887fc56e3b511a6d |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-04-10T20:18:14Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-d899a0dd77cf44c4887fc56e3b511a6d2023-01-26T04:44:36ZengElsevierInternational Journal of Infectious Diseases1201-97122023-02-01127137143Impact of point-of-care C-reactive protein testing intervention on non-prescription dispensing of antibiotics for respiratory tract infections in private community pharmacies in Nigeria: a cluster randomized controlled trialAugustine Onwunduba0Obinna Ekwunife1Ebuka Onyilogwu2Department of Pharmaceutical Microbiology and Biotechnology, Nnamdi Azikiwe University, Awka, Nigeria; Corresponding author: Tel: +2347061175220Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, NigeriaDepartment of Pure and Industrial Chemistry, Nnamdi Azikiwe University, Awka, NigeriaObjectives: To ascertain if access to C-reactive protein (CRP) test kits—and staff training on how to use them in respiratory tract infection (RTI) management—in private community pharmacies (PCPs) can reduce non-prescription antibiotic dispensing for RTI. Methods: A parallel cluster randomized controlled trial was conducted in Nigeria. The clusters—which were equally the participating units—were PCPs with blood testing experience. Stratified block randomization was done. PCPs were stratified by the baseline value of the primary outcome. PCPs were not blinded. The intervention PCPs were provided with CRP kits and trained to use them to make decisions regarding non-prescription antibiotic dispensing for RTI. The control PCPs received no intervention. The primary outcome was the non-prescription antibiotic dispensing rate for RTI. Data were collected by blinded simulated clients who visited each PCP 30 times before and after the intervention without prescriptions. Analyses were by intention-to-treat. Results: Twenty PCPs were randomized, 1:1. Ten PCPs were analyzed in each arm. Each PCP contributed 30 data points to the multiple imputation analysis where antibiotic dispensing decreased by 15.66% (209/300 [intervention] vs 256/300 [control]) in the adjusted analysis (odds ratio = 0·279, 95% confidence interval = 0.107-0.726; P-value = 0.0090) and 16% (208/300 [intervention] vs 256/300 [control]) in the crude analysis (odds ratio = 0.299, 95% confidence interval = 0.098-0.911; P-value = 0.034). Conclusion: Access to CRP kits—and staff training on how to use them in RTI management—in PCPs reduced non-prescription antibiotic dispensing for RTI.http://www.sciencedirect.com/science/article/pii/S1201971222006440AntibioticsC-reactive proteinCommunity pharmaciesCluster randomized controlled trialRespiratory tract infections |
| spellingShingle | Augustine Onwunduba Obinna Ekwunife Ebuka Onyilogwu Impact of point-of-care C-reactive protein testing intervention on non-prescription dispensing of antibiotics for respiratory tract infections in private community pharmacies in Nigeria: a cluster randomized controlled trial International Journal of Infectious Diseases Antibiotics C-reactive protein Community pharmacies Cluster randomized controlled trial Respiratory tract infections |
| title | Impact of point-of-care C-reactive protein testing intervention on non-prescription dispensing of antibiotics for respiratory tract infections in private community pharmacies in Nigeria: a cluster randomized controlled trial |
| title_full | Impact of point-of-care C-reactive protein testing intervention on non-prescription dispensing of antibiotics for respiratory tract infections in private community pharmacies in Nigeria: a cluster randomized controlled trial |
| title_fullStr | Impact of point-of-care C-reactive protein testing intervention on non-prescription dispensing of antibiotics for respiratory tract infections in private community pharmacies in Nigeria: a cluster randomized controlled trial |
| title_full_unstemmed | Impact of point-of-care C-reactive protein testing intervention on non-prescription dispensing of antibiotics for respiratory tract infections in private community pharmacies in Nigeria: a cluster randomized controlled trial |
| title_short | Impact of point-of-care C-reactive protein testing intervention on non-prescription dispensing of antibiotics for respiratory tract infections in private community pharmacies in Nigeria: a cluster randomized controlled trial |
| title_sort | impact of point of care c reactive protein testing intervention on non prescription dispensing of antibiotics for respiratory tract infections in private community pharmacies in nigeria a cluster randomized controlled trial |
| topic | Antibiotics C-reactive protein Community pharmacies Cluster randomized controlled trial Respiratory tract infections |
| url | http://www.sciencedirect.com/science/article/pii/S1201971222006440 |
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