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Choosing Wisely Canada: Viral prescription for URTIs
Choosing Wisely Canada: Viral prescription for URTIs
Updated over a week ago

The Viral Prescription tools integrate Choosing Wisely Canada's (CWC) tools and recommendations for the management of upper respiratory tract infections (URTI) from their Using Antibiotics Wisely in Primary Care campaign. The campaign aims to help reduce unnecessary antibiotic use while still meeting patient expectations of receiving a prescription for their infection.

A "viral prescription" (form) provides information about treatments that can improve a patient's URTI symptoms. When necessary, you may choose to provide an actual prescription with a future start date and add a "delayed prescription" (form) that contains information about treatment options.

A Cough, Cold and Flu Qnaire contains an information page for the patient, explaining the use and risks of antibiotics. A Cough, Cold and Flu encounter template contains specific treatment options, to indicate you've given a viral prescription or a delayed prescription with a handout.

Before you start using the new tools, you must ensure your system is configured appropriately (see steps below).

Content included

  • Cough, Cold and Flu - CWC Qnaire

  • Cough, Cold and Flu - CWC encounter template that contains specific treatment options

  • Viral prescription - CWC form

  • Delayed prescription - CWC form

Configuration

Complete the items below to ensure your system is configured to use the new tools. You only need to do this once.

  • Ask TELUS Health to add the content listed above to your domain.

  • Replace an older version of the Cough, Cold and Flu Qnaire with the new Qnaire, if applicable. Ensure the new Qnaire is linked to the presenting issues and/or appointment type, based on your clinic's scheduling configurations. (See Attaching pre-visit Qnaires to appointment types and/or Creating presenting issues for more information). You may want to unpublish or delete the older version of the Cough, Cold and Flu Qnaire; this can be done by a user who has permissions to edit Qnaires.

  • Replace an older version of the Cough, Cold and Flu encounter template with the new template, if applicable. You may want to delete the older version of the Cough, Cold and Flu encounter tempate; this can be done by a user who has permissions to edit encounter templates.

  • Test using the new tools as a patient and as a provider. We always suggest you walk through the steps of booking an appointment and completing a Qnaire whenever changes have been made to your scheduling settings or when a new Qnaire is added. Similarly, have a clinical team member use the new encounter template and forms to ensure they are functioning as expected.

Steps

1. The patient completes the Cough, Cold and Flu - CWC Qnaire when they book an appointment for cold symptoms. At the end of the Qnaire, an information page about antibiotics is displayed, in order to set their expectations.

2. When the patient checks in for their visit, start an encounter as you normally would.

3. In the Assessment and Plan section of the encounter, click the Treatment variable and select the appropriate option from the list:

  • If you determine the patient has an URTI and does not need antibiotics, select Patient was given a viral prescription using the standard form provided by CWC.

  • If you determine the patient has an URTI and may need antibiotics, select A delayed prescription for antibiotics was provided to the patient along with a patient handout from CWC.

4. If necessary, in the Prescriptions section of the encounter, add a prescription for an antibiotic with a future start date. You may also want to include Additional Instructions to indicate the patient should not immediately start taking the antibiotics.

5. In the Attachments section of the encounter, click Add Form.

  • If the patient does not need antibiotics, select the Viral Prescription - CWC form.

  • If the patient will receive a delayed prescription, select the Delayed Prescription - CWC form.

6. Complete the form and click Save.

7. Provide a copy of the form to the patient (e.g. by printing or sending it in a message to the patient).

Updated February 3, 2022

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