National guideline program to reduce unnecessary antibiotics for colds and flu-like illnesses in Swiss primary care
Effectiveness and Implementation of a National Guideline for Acute Respiratory Tract Infections to Reduce Antibiotic Prescribing in Swiss Primary Care: the ImpProGUIDE Hybrid Type II Effectiveness-implementation Trial
This project will test whether training family doctors to use new Swiss guidelines, point-of-care CRP testing, and shared decision-making can reduce unnecessary antibiotic prescriptions for adults with acute respiratory or flu-like illnesses in primary care.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 200 (estimated) |
| Sex | All |
| Sponsor | Center for Primary Care and Public Health (Unisante), University of Lausanne, Switzerland Academic / other |
| Locations | 1 site (Lausanne, Canton of Vaud) |
| Trial ID | NCT07396428 on ClinicalTrials.gov |
What this trial studies
The ImpProGUIDE program implements new Swiss acute respiratory infection guidelines through a multifaceted approach of physician training, quality circles, and support for point-of-care C-reactive protein (CRP) testing and shared decision-making. It uses a hybrid effectiveness–implementation design delivered in quality circles and walk-in clinics across several French- and Italian-speaking cantons to track both prescribing changes and guideline uptake. Participating clinics and physicians will receive training sessions and materials while the study collects prescribing data and provider surveys to monitor outcomes and implementation processes. The focus is outpatient adult primary care, where most community antibiotics are prescribed, with the aim of reducing prescriptions for likely viral infections.
Who should consider this trial
Good fit: Adults presenting to participating Swiss primary care or walk-in clinics with acute respiratory symptoms or influenza-like illness are the intended patient group for the intervention.
Not a fit: Patients with confirmed bacterial infections requiring antibiotics, hospitalized patients, children if not served by participating clinics, or people treated outside the listed cantons are unlikely to benefit from this specific program.
Why it matters
Potential benefit: If successful, the program could reduce unnecessary antibiotic use in primary care and help slow the spread of antibiotic resistance.
How similar studies have performed: Prior primary care trials in Europe have shown that CRP point-of-care testing combined with clinician communication training can substantially reduce unnecessary antibiotic prescribing, though implementation success varies by setting.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion criteria for quality circles (QCs) * Willing to participate in a study mainly conducted in French * Agreeing to participate in evaluation surveys Exclusion criteria for QCs\* \- Not having any physician included in the study Inclusion criteria for walk-in clinics * The clinic offers general practice/primary care medicine consultations, including emergencies * The clinic includes at least five physicians * The clinic has an "Admission to practice charged to Swiss compulsory health insurance" * The clinic plans to still be active in April 2026 * Located in one of the following cantons: Vaud, Geneva, Valais, Fribourg, Jura, Neuchatel, Bern, Ticino. * Serving mainly adult patients * Willing to participate in the study Physicians in QCs fulfilling all of the following inclusion criteria are eligible for the study: * Registered primary care physicians * Specialist title in general internal medicine or practicing physician. * Practicing in one of the following cantons: Vaud, Geneva, Valais, Fribourg, Jura, Neuchatel, Bern, Ticino. * Participating in a QC or working in an outpatient clinic participating in the study\*. * Willing to participate in a study mainly conducted in French. * Agreeing to participate in evaluation surveys and agreeing to be invited to interviews Eligibility criteria for physicians in clinics : \- Having a clinical activity as primary care physician or supervising clinical activity of physicians in post-graduate training within a clinic included in the study The only exclusion criterion for physicians is planning to retire before April 2026. \*Note: not all physicians from a QC or a clinic are expected or required to participate individually in the study, but at least one should participate.
Where this trial is running
Lausanne, Canton of Vaud
- Unisanté — Lausanne, Canton of Vaud, Switzerland (Recruiting)
Study contacts
- Principal investigator: Yolanda Mueller, MD, PhD — Unisanté, Centre for Primary care and Public Health & University of Lausanne, Switzerland
- Study coordinator: Jelena Dunaiceva, MPH
- Email: jelena.dunaiceva@unisante.ch; imppro@unisante.ch
- Phone: +41 78 654 23 74
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.