Study title

The EEPRIS Study. Evaluation of Enhanced Paediatric Respiratory Infection Surveillance: Community and primary care-based feasibility cohort study.

Location

Ten GP surgeries within a ten mile radius of Bristol city centre. CCGs: Bristol, South Gloucestershire and North Somerset.

Research design

The University of Bristol (together with Public Health England) conducted an enhanced paediatric respiratory tract infection (RTI) microbiology surveillance feasibility cohort study, with nested qualitative research. A prospectively recruited, representative cohort of children was invited to contribute data regarding the incidence and symptom profile of RTIs, and the use of primary care services between February and July 2016. Parents, children and clinicians also contributed interview data.

Context

There is a growing burden on primary care clinicians, as well as a growing public health threat of increasing antimicrobial resistance (AMR). Respiratory tract infections (RTIs) are the most common problem managed by primary care with the majority occurring in children and around 50% of patients given antibiotics. It is not clear precisely what proportion of children with RTIs are brought to the attention of primary care, but it is clear that even small changes in consultation rates could have a significant impact on primary care resources .

We are planning a future intervention to help parents make better consultation decisions and we think real-time information regarding the community circulation of paediatric RTI illness profiles with associated microbiology, could be useful for parents and clinicians. The purpose of EEPRIS is to establish the feasibility of the data collection methods, including microbiological data.

The study aim

EEPRIS aims to assess the feasibility of collecting and using real time paediatric RTI symptom and microbiological data – the purpose of such data being to develop a clinician and/or parent-based intervention to improve primary care utilisation for paediatric RTI.

EEPRIS will inform the design of a future full scale RTI surveillance cohort study with a nested randomised controlled trial (RCT) of a real-time microbiology and illness profile intervention. EEPRIS will also provide evidence of the duration of community paediatric RTI and rates of consultation.

Practice feedback

Feedback of main study results will be offered to practices by a written report around the end of 2016. Feedback about the progress of the study is provided via contacts with the research team.

NB: Results of individual patients’ microbiological analysis will NOT be fed back to GPs. These are for research (not clinical/diagnostic) purposes only.

Ethical considerations

The study is conducted in accordance with the Research Governance Framework, NHS Research Ethics Committee and CCG approvals and University of Bristol guidance.

• Practice staff sent letters (via Docmail) to parents of children registered at the practice. The letter invites interested parents to contact the study team. The research team did not have access to any patient details unless they contacted the research team directly. 
• Patients were informed about risks and benefits of taking part before consenting to participate, and older children did not take part if they did not give their assent.
• All information provided by research participants will be treated confidentially and stored on an encrypted database and in locked cabinets only accessible by the research team. This includes patient data and clinician interview data and any notes taken at meetings.
• Participating parents were offered a £15 shopping voucher to thank them for contributing a full set of RTI data for any child within the study; and £5 for participating in an (optional) interview.

Participating GP surgeries

• Air Balloon Surgery
• Gloucester Road Medical Centre
• Kingswood Health Centre
• Lodgeside Surgery
• Malago Surgery
• Montpelier Health Centre
• Nightingale Valley Practice
• Pembroke Road Surgery
• Shirehampton Group Practice
• The Wellspring Surgery

Recruitment and screening process

View Participant Exclusion and Enrolment Flowchart (PDF, 391kB)

Study protocol

View study protocol without appendices: EEPRIS Study Protocol (without appendices) (PDF, 1,290kB)

V‌iew study protocol appendices only: EEPRIS Study Protocol Appendices (PDF, 9,833kB)