Impact of a Multimodal Intervention on Antibiotic Prescribing for Respiratory Infections in Primary Care (GRASP)

January 13, 2026 updated by: University Hospital, Caen

Impact of a Multimodal Intervention on Antibiotic Prescribing for Respiratory Infections in Primary Care: A Cluster-Randomized Trial

Antimicrobial resistance (AMR), considered one of the greatest global threats by the WHO, justifies the development of initiatives to promote appropriate antibiotic use-especially in primary care, where most antibiotics in France are prescribed and where misuse remains common.

We are proposing a cluster-randomized controlled trial to evaluate the effectiveness of a bimodal intervention combining: (1) improved communication about the circulation of respiratory viruses, and (2) strengthened collaborative practices between general practitioners and pharmacists through a multidisciplinary protocol aimed at verifying that prescribed treatment durations comply with guidelines.

The study will include six primary care practices (24 physicians), with three practices in each study arm.

The aim of this project is to assess whether the bimodal intervention can reduce the duration of antibiotic treatments for upper and lower respiratory tract infections. The first component (a "viral infection prescription" tool) focuses on reducing unnecessary treatment initiation, while the second (pharmacist-led review) aims to shorten excessive prescription durations.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

4500

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • France
      • Caen, France, 14000
        • Recruiting
        • CHU Caen Normandie
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

- Patient seen in consultation for an upper or lower respiratory tract infection (Angina, Acute bronchiolitis, Acute bronchitis, COPD exacerbation (AECOPD), Laryngitis, Acute otitis media (AOM), Serous or congestive otitis, Viral respiratory infection (e.g., influenza), Community-acquired pneumonia (CAP), Rhinitis / Nasopharyngitis, Acute sinusitis)

Exclusion Criteria:

- Patient under legal protection

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Control group
The primary care practices in the control group do not receive any intervention and continue patient management according to their usual practices.
Experimental: Intervention group

For the intervention group, two planned interventions will be planed and applied to the primary care practices:

  1. Use of the OPIV (Viral Infection Prescription Tool).
  2. A multidisciplinary collaboration protocol between general practitioners and pharmacists to evaluate antibiotic treatment durations. This intervention aims to strengthen collaborative practices. If a prescribed duration does not comply with recommendations, the pharmacist will discuss it with the prescriber, and the duration will be adjusted accordingly."
Other: Antibiotic prescribing according to guidelines
If necessary, the general practitioner prescribes antibiotics to patients consulting for an upper or lower respiratory tract infection, according to the guidelines.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of antibiotic treatment days prescribed for upper and lower respiratory tract infections.
Time Frame: The primary outcome is measured at the time of prescription (i.e. at the baseline)
The primary outcome of the study will be the number of antibiotic treatment days prescribed for upper and lower respiratory tract infections. This outcome is a composite measure reflecting the impact of both interventions. Antibiotic duration will be assessed by running a query in the electronic medical record system of the participating primary care practices. The primary outcome will be evaluated at the baseline.
The primary outcome is measured at the time of prescription (i.e. at the baseline)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University Hospital, Caen

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 1, 2025

Primary Completion (Estimated)

June 1, 2026

Study Completion (Estimated)

September 1, 2026

Study Registration Dates

First Submitted

December 12, 2025

First Submitted That Met QC Criteria

January 13, 2026

First Posted (Actual)

January 22, 2026

Study Record Updates

Last Update Posted (Actual)

January 22, 2026

Last Update Submitted That Met QC Criteria

January 13, 2026

Last Verified

December 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 24-0171

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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