Rapid respiratory microbiological point-of-care-testing in primary care: a randomised controlled efficacy trial with internal pilot and qualitative and quantitative investigation of microbial, behavioural and antibiotic mechanisms (the RAPID-TEST RCT)
Background and aims
RAPID-TEST is a NIHR-funded randomised controlled trial, which aims to investigate whether the use of a rapid microbiological Point-of-Care-Test (POCTRM) can reduce same-day antibiotic prescribing for patients presenting to their GP with a respiratory tract infection.
Respiratory tract infections (such as coughs, colds, flu, COVID-19 etc) are the most common problem managed by health services internationally. In the UK, GPs treat over half of these with antibiotics when this may not be appropriate. Overprescribing results in unnecessary side effects and fuels antimicrobial resistance, regarded as a top 10 threat to global public health.
Most respiratory tract infections are caused by viruses but antibiotics only work if the infection is caused by bacteria. If GPs knew whether a respiratory tract infection was caused by bacteria or a virus, they could prescribe antibiotics in a better way. Therefore, this trial is aiming to find out whether the use of a POCTRM can reduce same-day antibiotic prescribing for children and adults presenting to primary care with respiratory tract infections.
Who can take part?
If you are a child (at least 12 months old) or adult presenting to your GP practice for the first time in this illness, with your GP suspecting a respiratory tract infection, you may be able to take part in this trial.
What does the trial involve?
You will be asked to provide a nose and throat swab. You will then be allocated to either having the swab tested that day at your GP practice using the POCTRM and receiving the results (your swab will also be tested at a later date by a central laboratory), or for the swab to be tested at a later date by a central laboratory using the POCTRM and you will not receive any results. If you are allocated to have your swab tested that day at the GP, the results from the POCTRM may be used to help decide your treatment.
You will be asked to complete a Trial Diary about your symptoms, any antibiotic or antiviral medicines that you take and information about your health. The Trial Diary will need to be completed every day from when you present to your GP (Day 1) until your symptoms resolve or up to Day 28 (whichever is sooner). The trial research team will contact you regularly to support completion of the Trial Diary.
Two months after you present to your GP for this illness you will be asked to complete a short questionnaire and you will be offered a £20 voucher on completion of the questionnaire to thank you for your time. Some participants may also be asked if they would like to take part in an interview to talk about their experience of taking part in the trial.