This study consisted of secondary analyses of data obtained from
a multi-center, two-arm, parallel cluster randomized trial conducted
in a network of the 12 family practice teaching units (units of
randomization) affiliated with the Department of Family Medicine
and Emergency Medicine at Universite´ Laval in six different regions
of the Province of Quebec, Canada. The design, methods, and
findings of this trial have been described elsewhere [21–23]. The
trial was conducted in three phases: a) baseline data collection
(physician and patient recruitment) from July through October
2010; b) intervention (training of physicians in the experimental
group in DECISION+2, a training program in SDM) in November
2010, and c) post-intervention data collection (patient recruitment)
from November 2010 through April 2011.
The experimental group received a two-hour online tutorial
followed by a two-hour on-site workshop. They also received a
decision support tool. The training program addressed key elements
of the clinical decision-making process concerning antibiotic treatment
for acute respiratory tract infections (ARTIs) in primary care
and how physicians could share the information and the decision
with their patients. A detailed description of the DECISION+2
training has been published elsewhere [23]. The program also
informed them of CPGs produced by the Institut National
d’Excellence en Sante´ et Services Sociaux (INESSS) of the Province
of Quebec about first and second choices for antibiotics to treat
ARTIs [24]. These CPGs are well-known among Quebec family
physicians [25]. Physicians in the control group provided routine
care during the trial period and had no access to the online tutorial,
the on-site interactive workshop or the decision support tool.