Implementing telemedicine to improve appropriate antibiotic prescribing for acute respiratory tract infections
Active Project Grant Awarded Last action
- Award ID
- R01HS028814
- Recipient
-
Boston Medical Center Corporation UEI JZ8RQC4EMDZ5
- Awarding agency
-
Division of Grants Management
Agency for Healthcare Research and Quality, Department of Health and Human Services
- Obligated
- $2,961,866
Award facts
- Assistance listing
- 93.226 Research on Healthcare Costs, Quality and Outcomes
- Completion date 89% complete
- Originally
- Funding agency
- Center for Quality Improvement and Patient Safety Agency for Healthcare Research and Quality, Department of Health and Human Services
- Place of performance
- Roxbury, MA 02118, USA
Award details come from USAspending.gov.
Description
- Abstract
- Inappropriate antibiotic use for the management of acute respiratory tract infections (ARTIS) in ambulatory care is a major driver of antibiotic resistance and an urgent public health threat. Despite decades of research and interventions to increase evidence-based care for ARTIS, limited progress has been made. Telehealth visits (THVS) have the potential to improve arti management and antibiotic prescribing by addressing factors that influence inappropriate care and by implementing an approach that optimizes outcomes across populations. The shift to care via THVS necessitated during the peak of the covid-19 pandemic has created a climate of increased acceptability for telemedicine and an important opportunity to address this question. We propose to leverage the current innovative landscape of expanded use of telehealth to test whether THV approaches for ARTIS can address drivers of inappropriate care and improve management. We seek to conduct a rigorous implementation study using a mixed methods approach to develop and evaluate a multisite intervention designed to improve arti care. We will conduct the study in ambulatory healthcare settings from three diverse healthcare systems with patients of a wide range of racial and ethnic backgrounds, those for whom english is not their primary language, and those with disparities related to social determinants of health. Our study will first construct a prediction tool using retrospective data for arti encounters (acute sinusitis, pharyngitis, bronchitis, and viral upper respiratory tract infections) at the three sites. The prediction tool will be used to identify candidates for arti management via THV who are at low risk for poor outcomes. We will incorporate the tool into the workflow of ambulatory care to optimize appropriate triage to THVS. Second, we will use prior research by our team and other published data to define factors identified as barriers and facilitators for inappropriate prescribing for ARTIS. Using that background, materials will be developed to facilitate appropriate management and to educate patients. Those materials will be created via CO-production with providers and community members. Patient materials will be translated in languages reflective of the patient populations served and be culturally sensitive. We will next conduct open pilot testing at hospital-based clinics at each of the three participating healthcare systems to refine the process and materials and get feedback from both patients and providers for adaptation and improvement. Finally, we will implement the approach across six sites - the sites where the three open pilots were conducted and three affiliated community practices. We will study outcomes including antibiotic prescribing, need for follow-up visits and encounters, and patient and provider satisfaction with the THV, the process, and the medical care. Based on our assessment of outcomes, including feasibility and sustainability, final materials will be organized into a toolkit for other sites to implement.
Transactions
| Action | Obligated | Date |
|---|---|---|
| Amendment | $0 | |
| Amendment | $0 | |
| Amendment | $483,567 | |
| Amendment | $487,417 | |
| Amendment | $0 | |
| Amendment | $495,441 | |
| Amendment | $0 | |
| Amendment | $495,441 | |
| Amendment | $500,000 | |
| Original award | $500,000 |
Subawards
| Subrecipient | Amount | Awarded |
|---|---|---|
| University Of Massachusetts Medical School | $47,626 | |
| Lahey Clinic, Inc. | $49,612 | |
| Trustees Of Boston University | $28,547 | |
| Lahey Clinic, Inc. | $7,500 | |
| Lahey Clinic, Inc. | $48,410 | |
| University Of Massachusetts Medical School | $23,412 | |
| Beth Israel Deaconess Medical Center, Inc. | $55,528 | |
| Lahey Clinic, Inc. | $40,698 |
Quick answers
Who received award R01HS028814?
R01HS028814 was awarded to Boston Medical Center Corporation by Division of Grants Management (Agency for Healthcare Research and Quality) on June 1, 2022.
How much is award R01HS028814 worth?
$2,961,866 has been obligated on R01HS028814.
Which agency awarded R01HS028814?
Division of Grants Management (Agency for Healthcare Research and Quality) awarded R01HS028814, with funding from Center for Quality Improvement and Patient Safety (Agency for Healthcare Research and Quality).
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