REDARES
RedAres project - Observation of prescription behaviour in the treatment of patients with uncomplicated urinary tract infections in an ambulatory practice setting
Official REDARES project homepage (www.redares.de)
In the treatment of infectious diseases, general practitioners find themselves caught between the goal of using medication sparingly, the patient's wishes and concerns about not treating complicated cases intensively enough in times of work intensification and cost pressure. An individual medication or antibiotic prescription is influenced by numerous factors.
The aim of the REDARES study is to optimize the treatment and prescription of medication for uncomplicated urinary tract infections in women. The participating practices and their patients benefited from individual prescription feedback, information materials and handouts both during and after the study. The multimodal intervention was successful, in the intervention group:
- 13% fewer second-line antibiotics were prescribed in 12 months
- 8% fewer antibiotic prescriptions (total) in 12 months
- The intervention proved to be feasible and was accepted in practice
- Feedback and resistance data were the most effective components of the intervention
The project began on September 1, 2019, with the Robert Koch Institute initially surveying and presenting the current pathogen and resistance situation in uncomplicated UTIs in five regions of Germany. Using modeling, the current and regional proportions of resistance in uncomplicated UTIs were calculated and made available to the participating GPs in the long term (subproject a).
The 12-month randomized controlled trial with a complex intervention on the procedure for uncomplicated UTIs started in April 2021 in a total of 138 GP practices. In the four federal states of Bavaria, Thuringia, Baden-Württemberg and Berlin/Brandenburg, previous and future prescribing behavior was recorded and reported back through feedback mechanisms (subproject b).
The accompanying process analysis of technical feasibility and acceptance enabled a subsequent direct transfer to standard care (sub-project c). A corresponding handout is freely available on the project website.
The project ended on December 31, 2022 and resulted in numerous publications:
2021 | Gágyor I, Greser A, Heuschmann P, Rücker V, Maun A, Bleidorn J, Heintze C, Jede F, Eckmanns T, Klingeberg A, Mentzel A, Schmiemann G. REDuction of Antibiotic RESistance (REDARES) in urinary tract infections using treatments according to national clinical guidelines: study protocol for a pragmatic randomized controlled trial with a multimodal intervention in primary care. BMC Infect Dis (2021) 21:990 https://doi.org/10.1186/s12879-021-06660-0 Zugriff: https://rdcu.be/cylkj |
2022 | Inga Petruschke, Kathleen Stichling, Alexandra Greser, Ildiko Gagyor,Jutta Bleidorn, Hausärztliche Perspektiven auf eine multimodale Intervention zumadäquaten Einsatz von Antibiotika beim Harnwegsinfekt – einequalitative InterviewstudieThe general practitioner perspective of a multimodal intervention for the adequateuse of antibiotics in urinary tract infection – a qualitative interview study |
2023 | Schmiemann G; Greser A; Maun A; Bleidorn J; Schuster A;Miljukov O; Rücker V; Klingeberg A; Mentzel A; Minin V; Eckmanns T; Heintze C; Heuschmann P; Gágyor I,. Effects of a multimodal intervention in primary care to reduce second line antibiotic prescriptions for urinary tract infections in women: parallel, cluster randomised, controlled trial. BMJ 2023; 383 doi: https://doi.org/10.1136/bmj-2023-076305 |
2023 | Angela Schuster, Paula Tigges, Julianna Grune, Judith Kraft, Alexandra Greser, Ildikó Gágyor, Mandy Böhme, Tim Eckmanns, Anja Klingeberg, Andy Maun, Anja Mentzel, Guido Schmiemann, Christoph Heintze, Jutta Bleidorn; GPs' perspective on a multimodal intervention to enhance 2 guideline-adherence in uncomplicated urinary tract infections: 3 a qualitative process evaluation of the multicentric RedAres 4 cluster-randomized controlled trial. Antibiotics 2023, 12, x. https://doi.org/10.3390/xxxxx |
2024 | Klingeberg, Anja; Willrich, Niklas; Schneider, Marc; Schmiemann, Guido; Gágyor, Ildikó; Richter, Doreen; Noll, Ines; Eckmanns, Tim; Erfassung der Resistenzanteile bei ambulant erworbenen unkomplizierten Harnwegsinfektionen |
Participants in the REDARES project
REDARES ran for 3 years and was financed by the Innovation Fund of the Federal Joint Committee (G-BA). The REDARES project was led by the Department of General Practice at the University Hospital Würzburg. Further project partners were:
Universities/Institutes
- University of Würzburg, Institute for clinical Epidemiology and Biometry (IKE-B), Würzburg, Germany
- Clinical Trial Centre Würzburg, University Hospital Würzburg, Germany
- Division of General Practice, Faculty of Medicine, Medical Center - University of Freiburg, Germany
- University Hospital Jena, Department of General Practice, Jena, Thuringia, Germany
- University Medicine Berlin, Department of General Practice, Berlin, Germany
- University of Bremen, Department of Health Services Research, Institute for Public Health and Nursing Research, Bremen, Germany
- Robert-Koch-Institut, Berlin, Germany
Health insurance companies
AOK Baden-Württemberg
