A PRimary care trial of a website based Infection control intervention to Modify Influenza-like illness and respiratory infection Transmission

ISRCTN ISRCTN75058295
DOI https://doi.org/10.1186/ISRCTN75058295
Secondary identifying numbers 09/800/22
Submission date
02/11/2010
Registration date
10/01/2011
Last edited
21/09/2021
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Infections and Infestations
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Study website

Contact information

Prof Paul Little
Scientific

Primary Medical Care
Aldermoor Health Centre
Aldermoor Close
Southampton
SO16 5ST
United Kingdom

Study information

Study designRandomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typePrevention
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleA primary care trial of a website based infection control intervention to modify influenza-like illness and respiratory infection transmission: a randomised controlled trial with a nested viral study
Study acronymPRIMIT
Study objectivesWe hypothesise that:
1. The intervention will reduce the number of episodes of influenza-like illness and respiratory tract infections (by reducing transmission) and hence the number of days with symptoms
2. The intervention will reduce the number of health service contacts by reducing the number of episodes
3. The intervention will change attitudes, beliefs, intentions, and behaviour
Ethics approval(s)NRES Southampton and West Hampshire REC (A), 10/04/2008, ref: 08/H0502/14
Health condition(s) or problem(s) studiedRespiratory tract infections, influenza
InterventionInfection control website:
Our key intervention will be access with a personal password to a website providing advice on infection control behaviours, with reinforcement by email reminders to use the site. A website is likely to be the most efficient and cost-effective mode of delivery in a pandemic as the majority of homes now have access to the web and the figure rises each year (National Statistics; August 2006). Currently more than 60% of households have access to the web and the figure goes up year on year by 5% each year in a linear fashion - which suggests that even by the end of this trial 80 - 90% of families could have home access to the web. The website will be tailored to provide targeted advice based on the factors that have been shown to be important influences on behaviour in the qualitative study and survey carried out in the development phase. The randomised individual (the index person) will be the main target for behaviour change which should limit spread from that person to members of the household and vice versa. Through the website and the individual passwords we will be able to monitor whether patients have used the website, and how often. Patients who have not used the website will be prompted by email to use the site. Following accessing of the website we will generate regular automated emails at monthly intervals as a reminder to use the website; these reminders will enable us to monitor compliance in the intervention group and give targeted advice.

Control group:
As in the intervention group, the control group will have access to the GP/practice in the normal way for respiratory illnesses and ILI (where low levels of antivirals are normally prescribed). They will have access to the intervention website at the end of the study.

All groups questionnaire follow up at month 1, 2, 3 and 4. Notes reviewed at 1 year.
Intervention typeOther
Primary outcome measureIndex patients will be prompted by email to log onto the website monthly to complete questionnaires about illnesses during the last month since the duration of symptoms can be remembered reliably over a period of a few weeks. For each episode the index person will document:
1. The nature of the infection
2. The duration of symptoms rated moderately bad (which we have shown is the most likely to be sensitive to change for individuals with cough and fever and can be remembered reliably over a period of a few weeks)
3. The number of days where work/normal activities were impaired
4. Whether other family members either had a similar infection before or after the index case, and what the time interval was
5. Whether contact with the health service was needed
6. How well the index patient and other family members complied with the target behaviours (for the intervention group only)

The monthly illness information will be supplemented by a questionnaire at the end of the winter documenting the summary information, and which can be validated against the monthly information. We will base our definition of RTI on consensus definitions developed in previous studies - which have defined a respiratory tract infection as 2 symptoms of an RTI for at least 1 day or 1 symptom for 2 consecutive days. Evidence of transmission will be defined as a respiratory illness developing within a week of another family member.
Secondary outcome measuresAt the end of the study all patients' GP notes will be reviewed to document admission to hospital for respiratory or cardiovascular complications, whether patients attended the GP for their ILI or other respiratory tract infections68, whether antibiotics or antivirals were prescribed, and/or any subsequent referrals. Assessment of the notes will be made blind to group, and has been shown to be reliable and unbiased. We will assess attitudes, beliefs, intentions, and self-reported adherence for each behaviour on 7 point Likert scales both in the pilot study (after 1 month and 3 months), and in the main trial at the end of the winter (we will randomly choose 1:20 patients for this outcome). These outcomes will be measured in both groups in the main trial only at the end of the winter, to minimise any effect on behaviour change of administering questionnaires in the control group. These outcomes will allow us to check whether the intervention is successful in effecting change and whether outcomes of the intervention are mediated by changes in these variables.To accompany the winter illness questionnaire we will use an adherence questionnaire (the 'Problematic Experiences of Therapy Scale'; PETS) that we have used in previous studies, including the MRC ATEAM trial, and two vertigo trials To reduce social desirability effects on reporting of adherence, the PETS asks patients to what extent they have been prevented from carrying out the intervention by socially acceptable reasons (e.g. symptoms too severe or aggravated by the intervention; doubts about efficacy; uncertainty about how to carry out the intervention; practical problems such as lack of time or opportunity, forgetting). They are only then asked how often and over how many weeks/months they adhered to each aspect of the intervention. To compare the effects of the intervention as a whole with the effects of the website and the target behaviours, in addition to the main intention-to-treat analysis we will carry out per protocol analyses to determine the effectiveness of the intervention in a) those who logged on to the website and b) those who reported adhering to each of the different target behaviours.
Overall study start date01/11/2007
Completion date01/06/2012

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants15,000
Total final enrolment20066
Key inclusion criteriaAdult patients (aged 18+ years, either sex) living with at least one other person
Key exclusion criteria1. GP notes show a skin problem that may affect handwashing ability
2. Live in households where no one else is willing to provide illness feedback
3. Terminal illness/severe mental health problems
4. Unable to complete online questionnaires
Date of first enrolment01/11/2007
Date of final enrolment01/06/2012

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Aldermoor Health Centre
Southampton
SO16 5ST
United Kingdom

Sponsor information

University of Southampton (UK)
University/education

c/o Martina Prude
Highfield
Southampton
SO17 1BJ
England
United Kingdom

Website http://www.soton.ac.uk/
ROR logo "ROR" https://ror.org/01ryk1543

Funders

Funder type

Government

Medical Research Council (MRC)/National Institutes of Health Research (NIHR) (UK) - Efficacy and Mechanism Evaluation (EME) Programme (ref: EME 09/800/22)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 09/12/2011 Yes No
Results article results 24/10/2015 Yes No
Results article process evaluation 30/05/2021 21/09/2021 Yes No

Editorial Notes

21/09/2021: The following changes have been made:
1. Publication reference added.
2. The total final enrolment number has been added from the reference.